Testicular Function in Critical Illness
Like other regulated endocrine axes, the hypothalamo—pituitary—testicular (HPT) axis in men is subject to modification from external influences. Both acute and chronic illnesses as well as numerous medications can profoundly affect levels of circulating testosterone and can inhibit spermatogenesis (1). In certain instances, such as hemochromatosis, the alteration in gonadal function is a well-recognized concomitant of the disease process, whereas in other circumstances, the apparent modification of gonadal function may simply represent a nonspecific effect of illness on the HPT axis (2). It is generally accepted that virtually any illness, whether acute, self-limited, or chronic, may have an impact on testicular function. The purpose of this chapter is to explore, specifically, the effects of critical illness and medications on the HPT axis. As well as discussing the possible pathologic consequences owing to these modifications of testicular function (3).
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