testosterone

Ovitrelle injection.

Since Pregnyl is no longer available in a lot of places I have had to switch to a different form of hCG injection.

The Ovitrelle pen is designed for female use and at 6,500 IU it is normally too high a dose for single use for males. The dose can be adjusted via the dial “clicks” to get the required dose.

The dose will be set by a health care professional depending on the testosterone level response.

hCG = human chorionic gonadotropin.

hCG is a natural hormone that mimics the activity of luteinising hormone (LH) which normally makes the testicles produce natural testosterone. LH is one of the two pituitary derived hormones that is missing in Kallmann syndrome / CHH patients.

Types of treatment for Kallmann syndrome / CHH.

Treatment for Kallmann syndrome / CHH can fall into two different types:

Hormone replacement therapy (HRT)

or

Fertility treatment - known as gonadotropin therapy.

Over the years I have been on many forms of HRT and have undertaken fertility treatment as part of clinical trials

Possible treatment methods for Kallmann syndrome / CHH

Some treatment methods will not be available in every country.

Some treatment methods may work better than others depending on the individual and it may take some discussion with the health care professional to find the method and dose that works best.

How is Kallmann syndrome / CHH diagnosed ?

There is no gold standard single test for Kallmann syndrome / congenital hypogonadotropic hypogonadism (CHH).

Diagnosis is often made by excluding other possible conditions that could affect puberty or fertility

Standard blood tests would include:

  1. Testosterone or oestrogen / progesterone

  2. LH

  3. FSH

  4. Prolactin

  5. SHBG

  6. Vitamin D

Other tests could include:

MRI to examine the size and structure of the pituitary gland and check to see if olfactory bulb is present.

Smell identication test.

Wrist x-ray to determine bone age.

DEXA / DXA bone density scan.

Hearing test.

Neurological exam to check reflexes.

Genetic testing may be undertaken whch can help in some cases, especially if there is a family history of the condition but not all cases of Kallmann syndrome / CHH can be identified through genetics.

What are the major symptoms of Kallmann syndrome ?

The defining symptom of Kallmann syndrome is a lack of sense of smell (anosmia) or a reduced sense of smell.

The condition can also occur with a normal sense of smell when the condition is called hypogonadotropic hypogonadism (HH).

There are other additional symptoms that may or may not occur. Kallmann syndrome or HH show a range of symptoms and patients may not experience any of them or only one them.

Possible additional symptoms:

  • Hearing loss

  • Cleft lip / palate

  • Fused fingers / toes

  • Missing teeth

  • Curvature of the back (scoliosis)

  • Mirror movements of the hands

  • Missing kidney

What is supposed to happen at puberty......

Kallmann syndrome is a known as a secondary hypogonadism condition.

This means the problem is with not with the testicles / ovaries themseleves but with the production of the hormones that should have been released at puberty.

One key hormone called GnRH.

GnRH is not released correctly at the time puberty is due.

In turn this prevents the pituitary gland from releasing two hormones called FSH and LH, collectively called gonadotropins.

Without these gonadotropins the ovaries and testicles remain dormant, puberty does not start or fully complete and no reproductive cycle is possible.

Not a late bloomer