Abstract
This chapter focuses on the individual components of the hypothalamicpituitary-gonadal axis, and provides an integrative sense of its control and the clinical manifestations associated with hormonal and spermatogenesis dysfunction. The male reproductive axis consists of six main components—the extrahypothalamic central nervous system, hypothalamus, pituitary, testes, sex-steroid-sensitive target organs, and sites of androgen transport and metabolism. The hypothalamicpituitary-testicular unit is an integrated system that assures the normal secretion of male hormones and the production of sufficient sperm for the propagation of the species. Each anatomical site is integrated with the others in a classic endocrine-feedback manner, with ample local modulation required for its most effective function. The Leydig cells of the testes are the site of production and secretion of testosterone, which through its direct action and that of its metabolites, dihydrotestosterone and estradiol, create the hormonal milieu required for normal male sexual development and function, and androgen- and estrogen-mediated effects on critical target organs such as the brain, bone, muscle, liver, skin, bone marrow, and immune system.
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