Endocrine Abstracts (2017) 51 MTE1 | DOI: 10.1530/endoabs.51.MTE1

Hypogonadism: from sex steroid replacement to options for fertility

Helena Gleeson


Birmingham.


The diagnosis of hypogonadism in a young person represents reduced sex steroid production and subfertility.

Optimising sex steroid replacement both in terms of preparation and dose occurs after pubertal induction. Clinical practice has changed in the UK in respect to females. The management of subclinical hypogonadism and benefits of testosterone replacement in male cancer survivors and klinefelter syndrome remain unclear. The endocrinologist needs to navigate carefully the concerns of parents in relation to impact on behaviour and concerns about personal hygiene in young people with learning difficulties while ensuring every attempt is made to establish them on bone protective sex steroid replacement.

Counselling young people with respect to their options for fertility and risks associated with pregnancy is an important aspect of transitional care. While hypogonadism is frequently lifelong there are groups of patients in whom resumption of gonadal function can occur either permanently or temporarily. This possibility needs to be discussed along with contraception if unwanted pregnancy is to be avoided. It also provides a window of opportunity for fertility preservation. Reevaluation of gonadal function is therefore recommended.

Through cases these aspects of hypogonadism will be explored.

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