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Harrison's Principles of Internal Medicine, 18e
| Part 16. Endocrinology and Metabolism > Section 1. Endocrinology > |
Chapter 346. Disorders of the Testes and Male Reproductive System
Sections: Disorders of the Testes and Male Reproductive System: Introduction, Development and Structure of the Testis, Normal Male Pubertal Development, Regulation of Testicular Function, Clinical and Laboratory Evaluation of Male Reproductive Function, Disorders of Sexual Differentiation, Disorders of Puberty, Disorders of the Male Reproductive Axis during Adulthood, Gynecomastia, Aging-Related Changes in Male Reproductive Function, Further Readings.
Topics Discussed: disorder of male reproductive system; testicular diseases.
Excerpt:"The male reproductive system regulates sex differentiation, virilization, and the hormonal changes that accompany puberty, ultimately leading to spermatogenesis and fertility. Under the control of the pituitary hormones—luteinizing hormone (LH) and follicle-stimulating hormone (FSH)—the Leydig cells of the testes produce testosterone and germ cells are nurtured by Sertoli cells to divide, differentiate, and mature into sperm. During embryonic development, testosterone and dihydrotestosterone (DHT) induce the wolffian duct and virilization of the external genitalia. During puberty, testosterone promotes somatic growth and the development of secondary sex characteristics. In adults, testosterone is necessary for spermatogenesis, stimulation of libido, normal sexual function, and maintenance of muscle and bone mass. This chapter focuses on the physiology of the testes and disorders associated with decreased androgen production, which may be caused by gonadotropin deficiency or primary testis dysfunction. A variety of testosterone formulations now allow more physiologic androgen replacement. Infertility occurs in  5% of men and is increasingly amenable to treatment by hormone replacement or by using sperm transfer techniques. For further..."
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