Hypogonadism natural history, complications and prognosis

If left untreated, patients with hypogonadism will end up with infertility and rheumatic autoimmune diseas. These autoimmune disease include rheumatic arthritis and systemic lupus erythematosus. Complications of hypogonadism depend on age and include ambiguous genitalia in the newborn, gynecomastia, and delay of puberty in the prepubertal phase. Complications also include depression and cardiovascular stroke in the adults. Prognosis of hypogonadism is regarded as good for patients who receive treatment and can have a normal life with appropriate medical therapy.

• If left untreated, patients with hypogonadism will progress and end up with infertility.
• Untreated testosterone deficiency and hypogonadism have been linked with rheumatic autoimmune diseases as rheumatoid arthritis and systemic lupus erythematosus.^[1]
• They also show an increase in the inflammatory markers as the following:
  • C reactive protein
  • Tumor necrosis factor
  • Interleukin 6

Complications of hypogonadism depend on the age of the patient. Complications that can develop are enlisted as the following:^[2]

• Fetal life:
  • Ambiguous genitalia which means genitalia unclear whether it is male or female.
• Puberty:
  • Gynecomastia
  • Complete delay of puberty
  • Impaired gonadal growth
• Adult:
  • Infertility
  • Type 2 Diabetes mellitus
  • Depression
  • Cardiovascular stroke
  • Myocardial infarction
  • Osteoporosis

• The prognosis of hypogonadism is good with treatment and patients can have a normal life with the appropriate medical therapy.^[3]

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