Köhn F-M
Klinik und Poliklinik für Dermatologie und Allergologie, Technische Universität München, München.
Urologe A. 2004 Dec;43(12):1563-81; quiz 1582-3. doi: 10.1007/s00120-004-0735-y.
Hypogonadism in men is defined as endocrine dysfunction of the testes, and due to reduced serum testosterone levels leads to symptoms of testosterone deficiency. Depending on the location of disruption in the endocrinological cycle, hypogonadism is classified as primary, secondary, or tertiary. In primary hypogonadism, the production of testosterone in the Leydig's cells of the testes does not function properly. Serum LH concentrations are elevated in the sense of counterregulation (hypogonadotropic hypogonadism). In secondary hypogonadism, LH secretion (and usually also FSH) from the hypophysis is impaired so that Leydig's cells are not stimulated, while in tertiary hypogonadism the hypothalamus is damaged. The clinical course in cases of reduced serum testosterone levels is determined essentially by the point in time when hypogonadism becomes manifest. Delayed puberty, eunuchoid stature, and underdeveloped secondary sex characteristics suggest prepubertal onset of hypogonadism.
男性性腺功能减退被定义为睾丸的内分泌功能障碍，由于血清睾酮水平降低导致睾酮缺乏症状。根据内分泌周期中功能紊乱的位置，性腺功能减退可分为原发性、继发性或三级。在原发性性腺功能减退中，睾丸间质细胞中睾酮的产生不能正常发挥作用。血清促黄体生成素（LH）浓度因反调节而升高（低促性腺激素性性腺功能减退）。在继发性性腺功能减退中，垂体分泌LH（通常还有促卵泡生成素，FSH）受损，因此间质细胞未受到刺激，而在三级性腺功能减退中，下丘脑受损。血清睾酮水平降低病例的临床病程主要取决于性腺功能减退出现的时间点。青春期延迟、类无睾体型和第二性征发育不全提示性腺功能减退在青春期前发病。
