[Pathogenetic interrelations of hypogonadism and depression in men].

Abstract

The study of the relationship between depression and functional hypogonadism in men is an interesting and difficult task. The purpose of the presented review was to identify the problem of functional male hypogonadism, to show a complex multi-stage neurohumoral mechanism of regulation of its potential to influence the affective sphere and to address the influence of pharmacotherapy on the formation of sexual disorders in men. The primary search for literature data was conducted using PubMed (Medline), PsycINFO and Cochrane CENTRAL, e-library.ru, databases using the keywords «hypogonadism», «depression», «testosterone», «antidepressants», «antipsychotics». As a result, 63 sources of information were selected and analyzed. Among the selected papers, there were 2 meta-analyses, 12 reviews and 42 comparative studies, including longitudinal, cross-sectional and controlled studies, 7 practical manuals. Based on the data obtained, it is possible to draw conclusions about the relationship between depression and functional hypogonadism as well as about the possibility of pathogenetic mechanisms of depression to cause changes in the state of the hypothalamic-pituitary-gonadal axis, leading to hypogonadism and vice versa, the ability of hypogonadism to form and enhance depressive symptoms. The concept of the mechanisms of regulation of steroidogenesis can allow the development of alternative methods of therapy and augmentation of depressive disorders, minimization of the number of sexual dysfunctions of psychopharmacotherapy. Further large-scale studies are needed for an in-depth study of this topic and the resolution of a number of contradictions.