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Excluding primary testicular failure and diabetes mellitus, endocrine disorders are uncommon but treatable causes ofmale infertility and erectile dysfunction. After treating the cause if possible, testosterone therapy induces puberty and normalizes erectile function in patients with hypogonadotrophic hypogonadism (HH). Infertility in patients with HH is treated by gonadotrophins, complemented with assisted reproductive techniques if necessary. The choice between dopamine agonists or surgery for the treatment of prolactinoma depends on tumour characteristics. The few studies available indicate that thyroid dysfunction is associated with impaired sperm quality. Recent evidence suggests that impaired spermatogenesis is associated with “subclinical” Leydig cell dysfunction. In these cases long-term follow-up of serum testosterone is recommended. The progressive increase in the incidence of male genital tract anomalies, male infertility and testicular cancer suggests a deleterious effect of environmental factors. The association of these pathologies is called “testicular dysgenesis syndrome, TDS”. Many studies suggest that TDS is caused by synthetic endocrine disrupters, mostly chemicals with (anti)oestrogenlike actions (xeno-oestrogens). |
