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Old 12-24-2003, 01:39 AM
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Default Distinguishing between primary and secondary testicular failure

What is the medical procedure for distinguishing between primary and secondary testicular failure?

How long should one spend trying to normalize T levels before testicular damage is the suspected culprit (primary)? I've heard some cases where doctors spend over a year trying to get the HPT axis back on try with eventually success.
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Old 12-24-2003, 07:35 AM
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If LH and FSH levels are low, same is diagnosis for secondary (hypogonadotrophic) hypogonadism. A problem here is that LH has a very short half-life, and its production is quite pulsatile, so serial draws must be done in order to develop a picture we can rely upon.

Gonadotrophins will be elevated in primary hypogonadism. There is also a "mixed' variety where both ends of the axis are deficient.

We should distinguish betwen acquired secondary hypogonadism (for instance secondary to AAS use) and the general decline in testosterone production brought on by age ("andropause"). In the second case, the problem is one of testicular failure, so no amount of "jump-starting" is going to result in any stiffness in the mornng other than the back.

I have had success restarting the HPTA in former steroid athletes, even long-term after cessation of anabolics. It's always worth a try, IF the patient wants to. Most simply prefer going straight to the Upjohn test cyp injections, though.
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Old 04-23-2006, 12:12 PM
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Default Distinguishing between primary and secondary testicular failure

Here are some links that may be helpful:

http://en.wikipedia.org/wiki/Hypogonadism

http://www.nlm.nih.gov/medlineplus/e...cle/001195.htm

http://www.emedicine.com/ped/topic1118.htm

http://www.merck.com/mrkshared/mmanu...er269/269g.jsp

http://www.pregnancy-info.net/infert...ogonadism.html
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Old 04-23-2006, 12:21 PM
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Default Re: Distinguishing between primary and secondary testicular failure

usually,primary results in high LH levels. secondary will result in low /low normal LH and FSH. its better to be secondary,if you had to choose.
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