Preface

Recent advances in cellular and molecular biology have markedly increased our understanding of normal and abnormal hypothalamic-pituitary-testicular function. Like other volumes in the Contemporary Endocrinology series, the goal of Male Hypogonadism: Basic, Clinical, and Therapeutic Principles is to link current knowledge of basic biology to the practice of medicine. The development of new methods for testosterone replacement has substantially increased the number of men who are seeking to determine whether they are hypogonadal, and who are using testosterone replacement therapy, thus mandating a broader understanding of testosterone deficiency.

The chapters of this book were contributed by authors from around the world, and from various scientific and clinical disciplines, who have devoted their careers to the study of the physiology and pathophysiology of the male. Thus, this comprehensive and focused volume is intended for a wide audience encompassing both basic scientists and practicing clinicians. Its scope will provide a wealth of information for students and fellows as well.

Chapters 1-3 review the neuroendocrine regulation of testicular function and provide an overview of Leydig cell steroidogenesis and the normal spermatogenic process in primates. The causes of gonadotropin deficiency and testicular failure are described in Chapters 4-10. The impact of chronic illness on testicular function is the focus of Chapters 11-13. Chapter 14 describes the endocrine mechanism for the decline in testicular function with aging. Chapter 15 summarizes the data supporting an impact of environmental factors on testicular function, whereas Chapters 16 and 17 discuss the testicular consequences of exercise and obesity. Finally, Chapters 18 and 19 provide an overview of androgen replacement therapy and an approach to stimulating spermatogenesis in gonadotropin-deficient men.

I wish to thank the contributors who spent many hours researching, pondering, and preparing their chapters, which collectively are exceedingly informative and clearly presented.

Stephen J. Winters, md

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