What is Hypogenitalism?Hypogenitalism is the inadequate education of the primary and secondary sexual characteristics. Here, the underdevelopment of the external genitalia is in the foreground.
Hypogenitalism is the inadequate education of the primary and secondary sexual characteristics. Here, the underdevelopment of the external genitalia is in the foreground. The male develops only a small penis. The scrotum is usually small and smooth. In extreme cases, there is even only one micropenis. In the woman, the fallopian tubes and uterus are not fully developed.
Both sexes also show an incomplete education of secondary sexual characteristics. Hypogenitalism and hypogonadism are closely related. Both terms should not be confused with each other. Hypogonadism is the hypofunction of the gonads such as the testicles or ovaries, with too little sex hormones being formed. The lack of sex hormones causes the underdevelopment of the sex organs (hypogenitalism).
However, hypogenitalism can have other causes. Thus, in some cases despite normal hormone concentration, the effectiveness of the sex hormones is reduced.
The causes of hypogenitalism are manifold. It should be noted that the underdevelopment of the reproductive organs is not an independent disease, but only a symptom of an underlying disorder or disease. Often there is a genetic cause. Various syndromes such as Klinefelter syndrome, Turner syndrome, Kallmann syndrome, Prader-Willi syndrome, or Laurence-Moon-Biedl-Bardet syndrome also have hypogly- malism as a symptom.
At least twenty different diseases or syndromes can lead to a disruption of genital development. In most cases, these diseases are genetically determined. They often lead to a hypogonadism to a lack of hormone production. In pseudohermaphroditism feminus, however, there is a male genotype XY with sufficient production of testosterone. However, due to ineffective receptors for testosterone, it may not be effective.
The affected person is phenotypically female, but without functioning female gonads present. In some cases, however, male and female sexual characteristics are equally present. This is called hermaphroditism (hermaphrodite).
But hypogenitalism can also be idiopathic. Here it comes to an isolated underdevelopment of the genitals without recognizable cause. It is possible that there is often a blurring of the boundary between normal and pathological genitalia due to the fuzzy definition.
As already mentioned, hypogenitalism is only a symptom of an underlying disorder. He expresses himself with the man in a small childish penis, which does not develop further even after puberty. Micropenis is spoken if it does not exceed a length of seven cm in the erected state. In addition, the prostate is barely feeling. Sometimes only a hazelnut-sized knot is palpable. The woman has underdeveloped uterus and fallopian tubes. The secondary sexual characteristics are insufficiently developed in both sexes.
Symptoms, complaints & signs
The additional symptoms depend on the underlying condition. If there is a testosterone deficiency, many more symptoms are added. The prerequisite for hypogenitalism is that the lack of testosterone already occurs before puberty. It shows delayed puberty, small testes, reduced fertility, muscle breakdown, female fat distribution, breast development, depression, other mental disorders and much more.
Sometimes there is hypogenitalism without any additional symptoms. When micropenis occurs, there is sometimes an intersexual disorder in which both male and female sexual characteristics are present. However, especially adolescents often suffer from mental disabilities. They often develop feelings of shame and shirk in front of their peers.
In rare cases, they even develop anxiety disorders or depression. As a rule, the affected persons are not impaired by the disturbance with regard to their erection and ejaculatory capacity. In most cases a normal sex life is possible for the person concerned. Sometimes, however, positions and methods need to be adjusted accordingly. The power of procreation is also unrestricted.
Diagnosis & disease course
To diagnose the underlying disorder in hypogenitalism, first the concentration of sex hormones is determined. Depending on the symptoms occurring, genetic tests can still be carried out. The range of possible syndromes is very large, so that differential diagnoses of various diseases are necessary.
Hypogenitalism primarily causes complaints to the sexual organs and their underdevelopment. This can lead to not only physical, but also mental complaints in the patient. In most cases, the amount of sex hormones in the patient is low, resulting in various behavioral disorders and growth disorders.
It is not uncommon for depression and other mental health problems. Those affected are often ashamed of the disease and its symptoms and thus suffer from inferiority complexes. The quality of life is also extremely limited by the disease. In most cases, hypogenitalism is treated by hormone therapy with no further complications.
If the symptoms do not disappear, the underlying disease is diagnosed. Complications can occur if treatment is not initiated and muscle breakdown or anemia occurs. Furthermore, it can also lead to impotence of the patient in serious cases.
However, if hypogenitalism is weak, no treatment is necessary in most cases if the condition does not particularly disturb the patient. Life expectancy is not reduced if treated early and correctly.
When should you go to the doctor?
If there is a developmental delay in children during the transition to puberty, a check-up should be carried out with a doctor. Equally worrying is a sudden early developmental stop in the training of the reproductive organs. A diminished breast development or small testicles should be presented to a doctor and examined.
If there are menstrual cramps, irregularities in the menstrual period or if the bleeding does not persist, consult a doctor. In case of sexual dysfunction, a loss of libido or visual abnormalities of the sexual organs, a doctor's visit is necessary. Emotional problems, anxiety or shame should be discussed with a doctor or therapist. Depressive periods, prolonged depressed mood, behavioral problems or a loss of vitality are signs that the person needs help and support.
A change of personality is a cause for concern and must be assessed by a doctor. Increased partnership conflicts, isolation or an unusual social behavior should be clarified by a doctor. An unfulfilled pregnancy desire, an unreasonable degradation of the muscles or a non-natural fat distribution on the body should lead to further medical examinations. A clarification of the cause is necessary so that no additional illnesses develop or the quality of life of the person affected decreases. Knot formations in the genital area are to be examined and treated as soon as possible.
Therapy & Treatment
When hypogenitalism is caused by a lack of sex hormones, hormone therapy is a good option. In male patients, testosterone may be delivered via injections or in the form of testosterone patches. Women receive female sex hormones such as estradiol, ethinylestradiol or the artificial sex hormone chlormadinone. The administration of sex hormones causes the subsequent development of primary and secondary sexual characteristics. However, it also depends on what the underlying disease is.
In Klinefelter syndrome, for example, there is a numerical chromosome aberration in the sex chromosomes. This is the status XXY. These are male patients with a primary testosterone deficiency. The testosterone administration causes here a clear improvement in the quality of life. In addition to the further development of the primary sexual characteristics, the hormone treatment also works against the existing anemia, muscle breakdown, osteoporosis, impotence and depression.
Some disorders also have their cause in the hormonal regulation system. There is no isolated lack of sex hormones here. For example, the pituitary gland may be affected as a central endocrine organ. In these cases, the cause must be uncovered and treated. You may also need hormone replacement therapy that includes other hormones. However, hypogenitalism is not always in need of treatment.
In idiopathic hypogenitalism, the question sometimes arises as to whether the size of the genital organ in this case is only outside the norm defined by definition.
Prevention of hypogenitalism does not exist. Most are hormonal disorders, which are often genetically determined. In principle, more than twenty different diseases and syndromes can lead to underdevelopment of the sexual organs. It should also be noted that hypogenitalism is usually only a symptom of an underlying disease.
In hypogenitalism, a follow-up in the medical sense purely due to the weak genitals is not necessary. These do not require treatment, but can be stimulated to grow thanks to hormone therapy. This usually has to be done for a lifetime, which can lead to regular checks and possibly a cessation of therapy.
However, the many different clinical pictures and syndromes, the symptom of which can be hypogenitalism, can force follow-up. These include, for example, the necessary follow-up measures after surgery in people with trisomy 21, as it often comes to organ malformations, or the follow-up measures in people with the Prader-Willi syndrome. The latter often cause diabetes and obesity with all complications.
Hypogenitalism can also put a heavy strain on those affected, which can lead to self-injurious behavior. Mental illnesses and subsequent therapy sometimes necessitate follow-up in the form of further discussions or other therapies.
Hypogonadism, which is very often the cause of hypogenitalism, is more often associated with osteoporosis. From this increased risk of bone fractures, it can also be deduced that aftercare for fractures is relevant. This does not affect all people affected by hypogonadism.
You can do that yourself
The means of self-help are limited in hypogenitalism. Patients are always dependent on a medical examination and therapy for this disease to defeat the symptoms of the disease.
The further treatment of hypogenitalism, however, depends very much on the underlying disease, but is usually carried out with the help of hormones. In most cases, the medical treatment completely restricts the discomfort, allowing patients to live a normal life. Above all, an early diagnosis of the disease leads to a rapid treatment without complications. The affected are only dependent on the regular intake of hormones. If the disease is diagnosed late, it can lead to disturbances in the development of the child. These disorders must be compensated by intensive therapy. Frequently, the parents can also promote their child accordingly to avoid complaints in adulthood.
In the case of mental complaints or inferiority complexes also help with a psychologist or therapist. This also conversations with family members or friends are. Through contact with other people affected by hypogenitalism, helpful information for everyday life can be collected.