Hypothalamic–Pituitary–Gonadal (HPG) Axis

by Carlo Raj, MD

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    Gonadotropic feedback axis differentials. Let’s do a little bit more important here. We have anabolic steroids. So here’s a patient, maybe an athlete. You ever heard of an athlete taking steroids? Oh you all? Of course. So, don’t judge them. You’re a doctor. You just take care of the issues and you educate your patient. That’s all you can do. But don’t judge them. You don’t know what environment they’re in. So, here’s your patient and they’re an athlete. I’m just being most common. They’re taking steroids iatrogenically. When you’re taking steroids, what then happens? What’s this major side effect that we’re all so familiar with taking steroids? Infertility. There you go. This is why. You’re taking sex steroids such as testosterone, anabolic. What then happens? Testosterone levels are increasing in the first column. Iatrogenically, you’re taking the steroids. What happens to anterior pituitary? Shut down, feedback mechanism, decreased LH and FSH. Now, if the patient is taking steroids from the outside world, it’s replacing the testosterone that are normally coming out of the gonads. If the patient now has decreased LH and FSH, you’re going to have testicular atrophy. Doesn’t this sound an awful lot like the most common cause of Cushing? Yes. What’s the most common cause of Cushing? Iatrogenic. Are you ever abruptly going to stop your patient from taking cortisol? No. Why? Because you’re pretty darn sure that if taking cortisol, you’ve now got the ACTH and the adrenals are undergoing atrophy. You’ve seen this already. It’s just a different scenario but the same concept. Let’s move on. Inhibin infusion, experimental. What does inhibin normally do? Jump to the last column. Majority or its major target will be FSH. It will decrease it. What if, now this is a better clinical situation. This will be more...

    About the Lecture

    The lecture Hypothalamic–Pituitary–Gonadal (HPG) Axis by Carlo Raj, MD is from the course Reproductive Hormone Disorders.

    Included Quiz Questions

    1. Ovaries
    2. Upper 2/3 of vagina
    3. Cervix
    4. Uterus
    5. Fallopian tubes
    1. Prostate and penis
    2. Rete testis
    3. Testicles and Seminiferous tubules
    4. Epididymis and Vas Deferens
    5. Seminal vesicles and Vas Deferens
    1. Prostate
    2. Epididymis
    3. Vas Deferens
    4. Seminal vesicles
    5. Seminiferous tubules
    1. Increase testosterone, increase spermatogenesis, decrease GnRH
    2. Decrease testosterone, decrease spermatogenesis, increase GnRH
    3. Increase testosterone, decrease spermatogenesis, increase GnRH
    4. Increase testosterone, decrease spermatogenesis, decrease GnRH
    5. Increase testosterone, increase spermatogenesis, increase GnRH

    Author of lecture Hypothalamic–Pituitary–Gonadal (HPG) Axis

     Carlo Raj, MD

    Carlo Raj, MD

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