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Decreased blood testosterone

Introduction
Cause
Examine
Diagnosis

Introduction

Introduction Male blood testosterone is 90% from the testis, which reflects the function of interstitial cells. Blood testosterone reduction is more common in male Turner syndrome, stromal cell hypoplasia, and no testis. Decreased testosterone levels cause male sexual dysfunction, primary testicular hypoplasia naive, hyperprolactinemia, pituitary dysfunction, systemic lupus erythematosus, hypothyroidism, osteoporosis, cryptorchidism, and men's breast development Testosterone levels are reduced.

Cause

Cause

Causes of decreased blood testosterone

The physiological characteristics of testosterone mainly include the following five aspects:

1 affects embryonic development and promotes the growth and development of male sexual organs. Testosterone can stimulate the growth and development of the prostate, penis, scrotum, urethral gland and other sexual organs;

2 stimulate the growth of reproductive organs and the appearance of sidelines. Testosterone can stimulate and maintain the male parasitic medical network, and can also produce and maintain normal sexual desire;

3 maintain spermatogenesis. After secretion from testosterone, testosterone can enter the seminiferous tubule through the basement membrane and bind to the corresponding receptor of spermatogenic cells to promote spermatogenesis;

4 affect metabolism. Testosterone can promote protein synthesis, especially protein synthesis in muscles and bones; affect water and salt metabolism, facilitate water and sodium retention in the body; increase calcium and phosphorus deposition in bone; 5 In addition, testosterone stimulates red blood cell production To increase the number of red blood cells in the body.

An abnormality in physiological function may cause an abnormality in blood testosterone concentration.

Examine

an examination

Related inspection

Testosterone male infertility HCG stimulation test drug stimulation test

Examination and diagnosis of blood testosterone reduction

Normal adult males have a blood testosterone level of 10 to 35 nmol/L (3 to 10 mg/L, RIA method).

Decreased testosterone: male sexual dysfunction, primary testicular hypoplasia naive, hyperprolactinemia, hypopituitarism, systemic lupus erythematosus, hypothyroidism, osteoporosis, cryptorchidism, men's breast development, etc. Testosterone levels are reduced.

Diagnosis

Differential diagnosis

Differential diagnosis of confusing symptoms caused by decreased blood testosterone

(1) XX male syndrome: the intrinsic sex chromosome is XX, no Y chromosome, HY antigen can be detected in serum, suggesting that X or autosome has a small amount of Y insertion, which can not be found in vitro culture. Its phenotype is male, and the incidence rate is 1:20,000 to 24,000 in male infants. The patient lacks all female genitalia and has male psychological characteristics. The clinical manifestations are similar to Klinefelter syndrome: the testes are small and hard (generally less than 2 cm), often with male breast development, normal penis size or slightly smaller than normal adults, usually with a lack of sperm and a glassy change of the seminiferous tubule. Blood testosterone levels are reduced, estradiol levels are elevated, and gonadotropin levels are elevated. This type is clinically similar to the XXY/XY chimeric type. Short stature, mental retardation and personality changes are very light, and relatively rare, the incidence of hypospadias is increased.

(2) Male Turner syndrome: autosomal dominant inheritance, nuclear shape 46, XY, clinical manifestations of typical Turner syndrome: short stature, neck brace, elbow valgus, congenital heart disease, male phenotype. Often there are cryptorchidism, testicular shrinkage, seminiferous tubule dysplasia, sexual naive, blood testosterone decreased, serum gonadotropin levels increased. A small number of patients have normal testes and are able to have children.

(3) Interstitial cell hypoplasia: fetal interstitial cells secrete testosterone disorders, resulting in male pseudohermaphroditism. There are testicles but spermatogenic disorders. The vulvar deformity type is a female phenotype. The penis is similar to the clitoris and has a blind end vagina. However, there is no uterus or fallopian tube. It is found that there is primary amenorrhea in adolescence. The pubic hair and the hair are scarce. Patients with elevated FSH and LH values, GnRH test gonadotropin response, blood testosterone significantly lower, HCG stimulation did not increase.

(4) There is no testicular disease: the embryo is caused by infection, trauma, vascular embolism or testicular torsion, and the testis is completely atrophied and the disease is phenotype. Adolescent male secondary sexual characteristics are not developed, the external genital remains still naive, no testis, if not treated with androgen, the elixir body shape. Moderate secondary sexual characteristics can occur if residual or ectopic stromal cells secrete androgen. Blood testosterone levels are low, gonadotropins are significantly elevated, and testosterone is not increased after HCG stimulation.

(5) Adult interstitial cell hypofunction: also known as male menopausal syndrome. After the age of 50, men gradually develop sexual dysfunction, which may have personality and emotional changes. Blood testosterone is gradually reduced, gonadotropin is elevated, and sperm is reduced or absent.