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While low levels of Gonadotropin-Releasing Hormone (GnRH) can prevent or stop puberty and cause infertility, there is good news. In many cases, these problems can be reversed with time, treatment, and medical supervision. The only way to increase GnRH levels is to undergo hormone therapy. After therapy, you may still need to monitor hormone levels throughout your life. People with low GnRH levels have a higher risk of developing osteoporosis and diabetes, so make sure that you are managing these risks at the same time.
Steps
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Get testosterone therapy if you are male. Testosterone supplements are the primary way of treating GnRH deficiency for men. Testosterone is given either as a patch, a shot, or as a pill. You can start this therapy as early as twelve years of age. [1] X Trustworthy Source Nature Respected Multidisciplinary Scientific Journal Go to source
- Shots of testosterone are given once a month. In comparison, you will use the patch every other day or take the pill daily.
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Take estradiol if you are female. Women will be prescribed either a patch, gel, or a pill that contains estradiol, which they can start taking as young as 10 years old. This is a form of estrogen. At first, you will be given a small dose, which will be increased slowly over a period of one to two years. [2] X Trustworthy Source Nature Respected Multidisciplinary Scientific Journal Go to source
- After several months of estradiol therapy, your doctor may add progesterone or progestin to your treatment. You must be on estradiol first before you can add these to your treatment plan.
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Take gonadotropin injections to boost fertility. Low GnRH levels cause a lack of two hormones called gonadotropins. There are several types of gonadotropin, including Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH). You can get injections of these to help start puberty or to make you fertile. [3] X Research source
- Both men and women can undergo this therapy. Your doctor will decide if you need FSH, LH, or both.
- Other gonadotropins such as Human Chorionic Gonadotropin (hCG) or Human Menopausal Gonadotropins (hMP) may also be used, sometimes in combination with others.
- You may need to go to the doctor or hospital for these injections, but in some cases, you may be prescribed injections to give yourself at home.
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Get Pulsatile GnRH therapy if you want to have a baby. In both sexes, GnRH deficiency can cause infertility, but pustule GnRH therapy can help. Instead of injections, this hormone therapy gives you the missing gonadotropin hormones through an IV pump. Each treatment session can last between one and two hours. [4] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source
- Ask your doctor about getting a portable infusion pump, which will deliver GnRH in pulses over the course of 18 months, similar to an insulin pump for diabetes. [5] X Research source
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Visit the doctor. If you are concerned about delayed puberty, lack of periods (for women), or infertility, visit your primary care doctor first to determine if you have GnRH deficiency or another issue. They can refer you to a specialist called an endocrinologist if needed.
- If infertility is your only issue, you may only need gonadotropin injections. A doctor or fertility specialist can help.
- If you have not undergone puberty, you may have a serious deficiency. Boys may have undescended testicles, a lack of body hair, high-pitched voices, and small sexual organs. Girls will not get periods or grow breasts. [6] X Trustworthy Source Nature Respected Multidisciplinary Scientific Journal Go to source These issues start in the womb and are often diagnosed in childhood.
- If you do not have a sense of smell, tell your doctor. They may order a genetic test to see if you have Kallman Syndrome.
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Get a blood test to diagnose hypogonadism. If your doctor suspects you have a deficiency known as hypogonadism, they will do a blood test. They will draw blood before giving you an injection of GnRH. After this injection of GnRH, a second blood sample will be taken to see if your body produces the right hormones. [7] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source
- This test can also check how much testosterone or estradiol your body produces. It will determine if your problems come from low levels of GnRH or from an issue in your sexual organs.
- Your doctor might also want to order X-rays, take an MRI of you brain or do ultrasounds of the abdomen or pelvis in order to find the cause of your hypogonadism. This could also help them look for any complications or other associated effects.
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Monitor the condition to see if GnRH levels return to normal. After getting hormone treatment, you will need to frequently monitor levels to see if treatment is working. Furthermore, about 10% of men may see their symptoms completely reverse, in which case therapy will need to be stopped. [8] X Research source Monitoring may include:
- Blood tests to test hormone levels
- Examination of sexual organs
- Sperm counts (for men)
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Join a clinical trial. Because GnRH deficiency is considered rare, treatment can be difficult. If you are willing to experiment with new methods, you can try joining a clinical trial. While these trials are not guaranteed to work, they can give you access to cutting edge treatments, especially if previous treatments have failed.
- You can use Clinicaltrials.gov to find a clinical trial that you qualify for. You can also apply for the trial through this website.
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Increase your Vitamin D intake. Since people with GnRH deficiency have a high risk of developing osteoporosis, you can take steps to strengthen your bone density. Get plenty of sunlight to get Vitamin D naturally. You can also take supplements.
- Your doctor will want to use special X-ray tests to monitor your bone density over time.
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Take calcium supplements. Calcium is also very important to keep your bones healthy and strong. A diet high in calcium can help prevent the bone problems associated with low GnRH levels. [9] X Trustworthy Source PubMed Central Journal archive from the U.S. National Institutes of Health Go to source Eat calcium-rich foods like milk, leafy greens, and fortified wheat products. You can also take calcium supplements. [10] X Research source
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Reduce your risk of diabetes if you are a man. Men with GnRH deficiency may have a higher chance of developing Type II diabetes later in life. To avoid this risk, you should maintain a healthy weight by eating a balanced diet and exercising regularly. [11] X Trustworthy Source Nature Respected Multidisciplinary Scientific Journal Go to source
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References
- ↑ https://www.nature.com/nrendo/journal/v11/n9/full/nrendo.2015.112.html
- ↑ https://www.nature.com/nrendo/journal/v11/n9/full/nrendo.2015.112.html
- ↑ https://www.scielo.br/j/medical/a/ZV6WF38fXg6RsQHDmmmQ64h/?lang=en
- ↑ https://www.ncbi.nlm.nih.gov/pubmed/3138867
- ↑ https://www.clinicaltrials.gov/ct2/show/NCT02310074
- ↑ https://www.nature.com/nrendo/journal/v11/n9/full/nrendo.2015.112.html
- ↑ https://medlineplus.gov/ency/article/003709.htm
- ↑ https://rarediseases.org/rare-diseases/kallmann-syndrome/
- ↑ https://www.ncbi.nlm.nih.gov/books/NBK1334/
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