The treatment goals in this group of patients with hypogonadism are as follow: (1) reduce or eliminate the mass effects of the lesion; (2) correct hormonal deficiencies, including those that impair gonadal function; and (3) preserve residual pituitary function. The specific treatments for the various diseases discussed are beyond the scope of this chapter. However, most lesions are initially treated surgically to eliminate the mass effects. Androgen replacement therapy is used to correct hypogonadism. When fertility is desired, treatment with exogenous gonadotropins (hCG ± hFSH) is generally successful. Finally, when panhypopituarism is present, hormonal replacement therapy is mandatory.
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