A 16-year-old male presents with delayed pubertal signs and social immaturity. His lab values show low testosterone. He was administered GnRH and no LH was produced. HCG was administered which restored testosterone to normal levels.

Discuss male hypogonadism.
Explain hormone administration.
Is there a problem with the hypothalamus? Why or why not?

Citations: At least one high-level scholarly reference in APA from within the last 5 years Case Study Part 1: Endocrine System and Reproductive Essay Paper

Case Study Part 1: Endocrine System/ Reproductive

This case study concerns a teenager of 16 years presenting with delayed puberty and poor interpersonal skills making them socially immature. Investigations conducted in the laboratory show that he is having low or sub-optimal levels of testosterone. His medical history shows that he was given hormonal therapy in the form of gonadotropin-releasing hormone (GnRH) to try and correct his hypogonadism. However, this treatment failed to make him produce luteinizing hormone (LH) which is the hormone responsible for facilitating sexual development and maturity (Hammer & McPhee, 2018; Huether & McCance, 2017). Specifically, LH causes the production of testosterone (responsible for male sexual drive) by acting on the Leydig cells of the testicles. The same LH spurs sperm production in the seminiferous tubules of the testes. Human chorionic gonadotropin or HCG is a hormone that acts just like LH and can be administered through hormonal therapy. This 16 year-old male was then administered with HCG after the failure of the GnRH and this time round testosterone was successfully restored to its normal levels. The purpose of this paper is to discuss male hypogonadism, hormonal therapy, and the role of the hypothalamus in this case.

Male Hypogonadism

Male hypogonadism is a condition that occurs when the gonads or testes fail to produce enough testosterone or do not produce it altogether (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018). The condition will result in inadequate sexual development and sexual immaturity of the male child. Both teenagers and adults can be affected by hypogonadism. With the absence of adequate levels of testosterone, the male will experience low libido and absent sexual drive. The person is affected psychologically with a low self-esteem and social immaturity.

There are a number of causes of male hypogonadism. They include severe childhood immunizable infections such as mumps, undescended testicles, autoimmune disorders like Addison’s disease, and genetic disorders like Klinefelter’s syndrome amongst others (Hammer & McPhee, 2018; Huether & McCance, 2017; Jameson et al., 2018). The signs and symptoms of male hypogonadism include low libido or sexual drive, insomnia, low sperm count, loss of bodily hair, and erectile dysfunction amongst others. Case Study Part 1: Endocrine System and Reproductive Essay Paper

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Explanation of Hormone Administration

Hormone administration is hormonal replacement therapy (HRT) and is a type of corrective treatment that involves injecting a patient with the hormone that is deficient in their body. An example of hormone replacement therapy is the administration of GnRH or HCG as in the case study above. In other words, the mainstay of treatment in male hypogonadism is HRT (Thirumalai et al., 2017). However, it is essential and critical that the diagnosis is not confused with one of the differential diagnoses (Cook & Décary, 2019) as administration of a hormone that is not deficient may result to unpleasant physical changes in the body.

Is there a Problem with the Hypothalamus in this Patient?

There seems to be no problem with the hypothalamus. Rather, the problem is probably with the anterior pituitary gland. The rationale for this is that when the patient was given GnRH that is normally produced by the hypothalamus, no luteinizing hormone was produced (and hence no testosterone was produced). But when HCG that has the same actions such as LH was administered, testosterone levels came back to normal. This means that it is the anterior pituitary that has a problem in this case of male hypogonadism. Case Study Part 1: Endocrine System and Reproductive Essay Paper

Conclusion

Male hypogonadism is a condition that affects teenagers as well as adults. Its treatment is through hormone replacement therapy or HRT. In this case, GnRH can be administered if the problem is with the hypothalamus. However, if the problem is with the anterior pituitary gland where LH is produced, then HCG whose actions are similar to LH can be administered to the male to restore testosterone levels.

References

Cook, C.E., & Décary, S. (2019). Higher order thinking about differential diagnosis. Brazilian Journal of Physical Therapy, 24(1), 1-7. https://doi.org/10.1016/j.bjpt.2019.01.010 

Hammer, D.G., & McPhee, S.J. (Eds). (2018). Pathophysiology of disease: An introduction to clinical medicine, 8^th ed. McGraw-Hill Education.

Huether, S.E. & McCance, K.L. (2017). Understanding pathophysiology, 6^th ed. Elsevier, Inc.

Jameson, J.L., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., & Loscalzo, J. (Eds) (2018). Harrison’s principles of internal medicine, 20^th ed. McGraw-Hill Education.

Thirumalai, A., Berkseth, K.E., & Amory, J.K. (2017). Treatment of hypogonadism: Current and future therapies. F1000Research, 6(68), 1-10. https://doi.org/10.12688/f1000research.10102.1

Case Study Part 1: Endocrine System and Reproductive Essay Paper