Hypogenitalism

Hypogenitalism, a term that combines diseases associated with insufficiency of the sex glands. Insufficiency of the male sex glands is called hyporchidia, and of the female sex glands - hypovaria. -Etiology. Hypogenitalism can be congenital, constitutional, or acquired. The first form is associated either with direct hereditary factors (G. in the family, lineage) or with indirect ones, e.g., with hereditary syphilis, tuberculosis, alcoholism, or with the advanced age of parents. The acquired form is associated with castration (see Eunuchoidism), tumors and injuries of the sex glands, less frequently with acute infections (in particular with gonorrhea), leading to orchitis and oophoritis. In addition to primary hypogenitalism, secondary hypogenitalism is also distinguished, caused by bilateral cryptorchidism, hyper- or hypothyroidism, insufficiency of the pituitary or cortical layer of the adrenal glands; the development of the sex glands is also inhibited by the epiphysis and the thymus gland. Furthermore, functional hypogenitalism is also distinguished in practice, caused by severe fatigue, sexual excesses, etc. -The symptomatology of hypogenitalism depends partly on sex, but mainly on the age at which the signs of hypogenitalism begin to develop. For early hypogenitalism in men (before the period of sexual development), the characteristics are primarily anomalies of skeletal structure, expressed in disproportion between the upper and lower halves of the body, with predominance of the lower half (from the pubis to the ground) over the upper. French authors compare such subjects with long-legged birds. Due to delayed ossification, the long bones are long, which leads to tall stature. The size of the skull is average. The sexual apparatus, the prostate gland are underdeveloped. Libido is reduced or absent. Secondary sexual characteristics do not appear. Over the entire body, except for the head, there is hypotrichosis. The contrast between the narrowness of the chest and the large size of the pelvis, the width of the hips, is striking. Skeletal deformations - lordosis, kyphosis, flat feet, genu valgum - are common. The skin is thin, pale. The voice is high. Very often there is selective fat deposition in the area of the pubis, lower abdomen, and breasts. Hypogenital signs include: rudimentary development of the lateral incisors, marbling of the skin, absence of lower abdominal reflexes, absence of cremasteric reflexes, decrease in the amount of Hb in the blood and lymphocytosis. In body structure, patients with hypogenitalism are mostly dysplastic with an infantile facial profile. In terms of motor skills - insufficient mobility, clumsiness. G. in women gives a less clear picture of disorders. This is explained by the fact that in women, secondary sexual characteristics depend to a lesser extent on the influence of the sex glands. In general, the symptomatology is similar to that in male hypogenitalism. Menstruation appears late (at 15-16 years) or does not appear at all; sometimes menstruation that has appeared after several months completely disappears. Menstruation is scanty, painful (pain in the lower back, in the abdomen), accompanied by headaches, irritability, restless sleep, depressive state. In rare cases, alternation of periods of amenorrhea and meno- or metrorrhagia is observed ('ovarian ataxia'). Selective fat deposition is observed more often than in male hypogenitalism; furthermore, chlorosis is often observed. Very characteristic is acrocyanosis: moist, bluish, swollen extremities - hands and ankles (the so-called 'hypogenital extremities' according to Marañón). Phenomena of virilism are common: tendency to hypertrichosis of the trunk and extremities, beard, mustache, strong development of muscles. -Very characteristic are the features of the psyche in hypogenitalism: shyness, timidity, strong suggestibility, inability to make long-term volitional and emotional efforts. The psychological tempo is slow. No disturbances are noted in the area of formal intellect. Thinking is infantile, of a concrete type; tendency to sophistry. In cases of hypogenitalism after the period of sexual development, there are no skeletal disorders, secondary sexual characteristics are present. Characteristic is selective fat deposition, reduction of sexual functions and change in psyche (see Eunuchoidism). -Treatment. Replacement therapy gives some effect only in female hypogenitalism (ovarian tissue under the skin). In cases with severe obesity and reduced metabolism, good results were observed from the use of thyroidin. In recent years, injections of extracts from the anterior lobe of the pituitary have begun to be used. Regarding transplants of sex glands - see Eunuchoidism.