decreased testosterone production or action
Last reviewed 01/2018
Reduced testosterone production or action is often associated with increased plasma gonadotrophin levels but not necessarily, with increased plasma oestrogen.
Congenital causes include:
- Klinefelter's syndrome - seen in about 80% of Klinefelter patients, these patients clearly carries an increase risk (10-fold to 20-fold greater than normal) of breast cancer (1)
- testicular feminisation and Reifenstein syndrome
- congenital anorchia - rare - individuals are 46, XY males with normal male phenotype but missing testes. The testes are thought to have been present originally but then to have regressed late in embryonic life
- biochemical defects in testosterone synthesis
Secondary testicular failure may also occur in:
- viral orchitis - the most common cause of testicular failure after puberty; especially, mumps
- trauma - the second most common acquired cause in adults
- castration
- renal failure - gynaecomastia is found in half of the men undergoing haemodialysis for renal failure
- neurological diseases such as myotonic dystrophy - gynaecomastia occuring in three quarters of cases - and spinal cord lesions
- granulomatous disease such as leprosy
Reference: