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The pulsatile secretion of GnRH is the main activator of pituitary LH secretion, and thereby Leydig cell function. GnRH effects are balanced by feedback signals from the testes and by pituitary paracrine and autocrine regulatory mechanisms. It is now known that kisspeptin is the upstream director of the GnRH signal and is the driver of the obligatory pulsatile mode of GnRH secretion. This chapter reviews the fundamental workings of the hypothalamic-pituitary unit in males with a focus on humans, describes how the function of the kisspeptin-GnRH-LH axis varies across the lifespan, and selectively illustrates how it can be mechanistically disrupted by congenital and acquired illness. This is an extensive field, and this chapter reflects the author’s perspective and biases. Page limitations prevent the discussion of many important contributions.

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The Hypothalamus-Pituitary in Males in Health and Disease

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  • 发表日期：

    2025年

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  • Stephen J. Winters

摘要

The pulsatile secretion of GnRH is the main activator of pituitary LH secretion, and thereby Leydig cell function. GnRH effects are balanced by feedback signals from the testes and by pituitary paracrine and autocrine regulatory mechanisms. It is now known that kisspeptin is the upstream director of the GnRH signal and is the driver of the obligatory pulsatile mode of GnRH secretion. This chapter reviews the fundamental workings of the hypothalamic-pituitary unit in males with a focus on humans, describes how the function of the kisspeptin-GnRH-LH axis varies across the lifespan, and selectively illustrates how it can be mechanistically disrupted by congenital and acquired illness. This is an extensive field, and this chapter reflects the author’s perspective and biases. Page limitations prevent the discussion of many important contributions.