Sex hormones play an important role in sexual development and reproductive functions. Disorders can occur when hormone levels are too high or too low. Some common sex hormone disorders discussed in the document include erectile dysfunction in males, gynecomastia which is breast growth in males, hypogonadism meaning low sex hormones, and polycystic ovary syndrome (PCOS) in females. PCOS is characterized by irregular periods, excess hair growth, and obesity due to abnormal ovarian function and high androgen levels. Its causes may include excess insulin, inflammation, and heredity.

1. SEX HORMONE
DISORDERS

2. Introduction
• Sex hormones stimulate or control the sexual organs
and reproductive systems in both men and women.
• In women, hormones including estrogen,
progesterone and follicle-stimulating hormone (FSH)
are vital to menstruation and pregnancy.
• In men, sexual hormones are called androgens.
• The main androgen is testosterone.

3. • Usually, endocrine glands keep reproductive
hormones at the right levels, but many factors can
cause hormone levels to be too high or too low.
• This can lead to problems with sexual development,
fertility and more.

4. Disorders
1. Erectile dysfunction
2. Gynecomastia
3. Hypogonadism
4. PCOS (Polycystic ovary syndrome)
5. Hirsutism

5. 1. Erectile dysfunction
• Definition
• “The consistent inability to achieve and/or maintain an
erection adequate for satisfactory sexual intercourse”
• Persistent or recurrent inability to attain, or to
maintain until completion of the sexual activity, an
adequate erection

6. • Penile erection is a neurovascular event modulated by
psychological factors and hormonal status.
• On sexual stimulation, there is a n i n c r e a s e d flow of
blood into the lacunar network.
• Subsequent compression of the trabecular smooth muscle
causes a closure of the emissary veins and accumulation of
blood in the corpora. The corpora becomes non-
compressible and blood cannot escape.

7. Causes

8. Symptoms
• Erectile dysfunction symptoms might include persistent:
• Trouble getting an erection
• Trouble keeping an erection
• Reduced sexual desire

9. Pathogenesis

10. Risk Factors for ED
• Diabetes mellitus
• Cardiovascular disease
• Concurrence of other GU diseases
• Psychiatric or psychological disorders
• Chronic diseases
• Smoking Medications
• Hormonal factors also serve as well-defined risk factors

11. Diagnosis
• Physical exam
• Blood tests
• Urine tests (urinalysis)
• Ultrasound
• Psychological exam

12. Complications
• Complications resulting from erectile dysfunction can
include:
• An unsatisfactory sex life
• Stress or anxiety
• Embarrassment or low self-esteem
• Relationship problems

13. 2. Gynecomastia
• Gynecomastia is an increase in the amount of breast
gland tissue in boys or men, caused by an imbalance of
the hormones estrogen and testosterone.

14. Symptoms
• Signs and symptoms of gynecomastia include:
• Swollen breast tissue
• Breast tenderness

15. Causes
• Gynecomastia is triggered by a decrease in the amount of
the hormone testosterone compared with estrogen.
• The decrease can be caused by conditions that block the
effects of testosterone, reduce testosterone or increase
estrogen level.
• Most people think of estrogen as an exclusively female
hormone, but men also produce it — though normally in
small quantities.
• Male estrogen levels that are too high or are out of
balance with testosterone levels can cause gynecomastia.

16. Medications
1. Anti-androgens used to treat an enlarged prostate,
prostate cancer and other conditions.
2. Anabolic steroids and androgens, which are
prescribed by doctors for certain conditions or are
sometimes used illegally by athletes to build muscle
and enhance performance.
3. AIDS medications. Gynecomastia can develop in men
who are HIV-positive and receiving a treatment
regimen called highly active antiretroviral therapy.

17. • Anti-anxiety medications, such as diazepam (Valium).
• Tricyclic antidepressants.
• Antibiotics.
• Ulcer medications
• Cancer treatment.
• Heart medications (digoxin (Lanoxin) and calcium channel
blockers)

18. Risk factors
• Older age
• Use of anabolic steroids or androgens to enhance athletic
performance
• Certain health conditions, including liver and kidney
disease, thyroid disease, hormonally active tumors.

19. Complications
• Gynecomastia has few physical complications, but it can
cause psychological or emotional problems caused
by appearance.

20. Diagnosis
• Blood tests
• Mammograms
• Computerized tomography (CT) scans
• Magnetic resonance imaging (MRI) scans
• Testicular ultrasounds
• Tissue biopsies

21. Medications
• Medications used
conditions may
to treat breast
be helpful for
cancer
some
and other
men with
gynecomastia. They include:
• Tamoxifen (Soltamox)
• Aromatase inhibitors, such as anastrozole (Arimidex)

22. 3. Hypogonadism
• “Hypogonadism occurs when sex glands produce little or no
sex hormones”
• The sex glands, also called gonads, are primarily the testes
in men and the ovaries in women.
• Sex hormones help control secondary sex characteristics, such
as breast development in women, testicular development
in men, and pubic hair growth.
• Sex hormones also play a role in the menstrual cycle
and sperm production.

23. Types of hypogonadism
• Primary hypogonadism
• Primary hypogonadism means that they don’t have
enough sex hormones in their body due to a
problem in gonads.
• Gonads are still receiving the message to produce
hormones from brain, but they aren’t able to produce
them.
• Central (secondary) hypogonadism
• In central hypogonadism, the problem lies in your brain.
Your hypothalamus and pituitary gland, which control
your gonads, aren’t working properly.

24. Causes of hypogonadism
• The causes of primary hypogonadism include:
• Autoimmune disorders, such as addison’s
hypoparathyroidism
disease and
• Genetic disorders, such as turner syndrome and klinefelter
syndrome
• Severe infections, especially mumps involving your testicles
• Liver and kidney diseases
• Undescended testes
• Hemochromatosis, which happens when your body
absorbs too much iron
• Radiation exposure
• Surgery on your sexual organs

25. • Central hypogonadism may be due to:
• Genetic disorders, such as kallmann syndrome (abnormal
hypothalamic development)
• Infections, including HIV
• Pituitary disorders
• Inflammatory diseases, including tuberculosis,
• Obesity
• Rapid weight loss
• Nutritional deficiencies
• Use of steroids or opioids
• Brain surgery
• Radiation exposure
• Injury to your pituitary gland or hypothalamus
• A tumor in or near your pituitary gland

26. Symptoms of hypogonadism
• Symptoms that may appear in females include:
• lack of menstruation
• slow or absent breast growth
• hot flashes
• loss of body hair
• low or absent sex drive
• milky discharge from breasts

27. • Symptoms that may appear in males include:
• loss of body hair
• muscle loss
• abnormal breast growth
• reduced growth of penis and testicles
• erectile dysfunction
• osteoporosis
• low or absent sex drive
• infertility
• fatigue
• hot flashes
• difficulty concentrating

28. Pathogenesis

29. Risk factors
• Risk factors for hypogonadism include:
• HIV/AIDS
• Previous chemotherapy or radiation therapy
• Aging
• Obesity
• Malnutrition

30. Complications
• Abnormal genitalia
• Enlarged male breasts (gynecomastia)
• Infertility
• Erectile dysfunction
• Osteoporosis
• Poor self-image

31. Hypogonadism diagnosis
• Hormone tests
• Imaging tests
• Semen analysis
• Pituitary imaging
• Genetic studies
• Testicular biopsy

32. Treatment for female hypogonadism
• Female : increasing amount of female sex hormones
• First line treatment: estrogen therapy
• Low dose testosterones
• Menstrual irregularities or trouble conceiving: injections
of the hormone human choriogonadotropin or pills

33. 4. Polycystic ovary syndrome
• Polcystic ovary syndrome is a condition in women
characterized by irregular or no menstrual periods,
acne, obesity, and excess hair growth.
• PCOS is a disorder of chronicallyabnormal ovarian
function and hyperandrogenism (abnormallly elevated
androgen levels)

34. Causes
• Excess insulin. Insulin is the hormone produced in the pancreas that allows cells
to use sugar, body's primary energy supply. If cells become resistant to the action
of insulin, then blood sugar levels can rise and body might produce more insulin.
Excess insulin might increase androgen production, causing difficulty with
ovulation.
• Low-grade inflammation. This term is used to describe white blood cells'
production of substances to fight infection. Research has shown that women with
PCOS have a type of low-grade inflammation that stimulates polycystic
ovaries to produce androgens, which can lead to heart and blood vessel
problems.
• Heredity. Research suggests that certain genes might be linked to PCOS.
• Excess androgen. The ovaries produce abnormally high levels of androgen,
resulting in hirsutism and acne.

36. Symptoms
• Irregular periods. Infrequent, irregular or prolonged
menstrual cycles are the most common sign of PCOS.
• Excess androgen. Elevated levels of male hormone may
result in physical signs, such as excess facial and body
hair (hirsutism), and occasionally severe acne.
• Polycystic ovaries. Ovaries might be enlarged and
contain follicles that surround the eggs. As a result,
the ovaries might fail to function regularly.

37. Pathogenesis

38. Complications
• Infertility
• Gestational diabetes or pregnancy-induced high blood pressure
• Miscarriage or premature birth
• Nonalcoholic steatohepatitis — a severe liver inflammation caused by
fat accumulation in the liver
• Metabolic syndrome Type 2 diabetes or prediabetes
• Sleep apnea
• Depression, anxiety and eating disorders
• Abnormal uterine bleeding
• Cancer of the uterine lining (endometrial cancer)

39. Diagnosis
• Here's no test to definitively diagnose PCOS.
• A pelvic exam.
• Blood tests.
• Analyzed to measure hormone levels.
• Measure glucose tolerance and fasting cholesterol and triglyceride
levels.
• An ultrasound.

40. Treatment
• Lifestyle changes
• Medications
• Combination birth control pills. Pills that contain estrogen and
progestin decrease androgen production and regulate estrogen.
• Progestin therapy. Taking progestin for 10 to 14 days every one to
two months can regulate periods and protect against endometrial
cancer.
• Clomiphene (Clomid). This oral anti-estrogen medication is taken
during the first part of menstrual cycle
• Metformin

41. Questions
1. Write a note on the disorder of the sex hormone
2. Write a short note on PCOS.

42. Thank You