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Medical Conditions

Medical Conditions According to the The Black Dog Institute, within the brain, the central neural drive of the reproductive processes in both sexes is the activation of neurons that produce gonadotropin releasing hormone (GnRH). It is probable that there are multiple factors that produce this pubertal awakening and the maintainence of adult functioning of GnRh release, including length of day and seasonal cues, nutrition as well as various kinds of stress.

At puberty, GnRH is released into the hypothalamus-pituitary portal vessels within the median eminence of the hypothalamus, travels to the anterior pituitary where it binds to the gonadotropin receptors causing the release of the gonadotropins, luteinizing hormone and follicle stimulating hormone and thence into the systemic circulation.

In males, luteinizing hormone stimulates testosterone production. Testosterone stimulates the development of secondary sexual characteristics and supports the functioning of the male secondary sexual organs. With follicle stimulating hormone it acts to stimulate spermatogenesis.

In females, follicle stimulating hormone causes the development of ovarian follicles at the beginning of each ovarian cycle. Follicle stimulating hormone and luteinizing hormone together stimulate mid-cycle ovulation as well as the cyclical production of the female ovarian steroid hormones, estrogen and progesterone hormones which in turn cause the development of, and support for, the female secondary sexual characteristics.

The cyclical fluctuations in the circulating gonadal steroid hormones, in turn, feedback to modulate the pulsatile release of GnRH, with estrogen having a positive feedback to the hypothalamic pituitary axis. As previously stated, various types of stress help maintain the adult functioning of the GnRH system. Three primary neurotransmitter systems are considered to mediate anxiety: the locus ceruleus-norepinephrine system, the serotonin system and the GABA-benzodiazepine receptor system.

The female gonadal steroid hormones act to mediate sensitivity to stress. Estrogen acts to reduce sensitivity to stress. However, recurrent cyclical estrogen withdrawal starting at puberty and finishing at the menopause may render women more vulnerable to stress by interfering with estrogen’s ability to neutralise the effects of glucocorticoids released during stress.

Men - Low Testosterone
For men, testosterone levels typically begin to drop after the age of 40 (sometimes referred to as ‘Andropause’ or ‘Male Menopause’), however, for some men hormonal changes will occur sooner.

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