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The HPG axis is responsible for the production of testosterone, the main sex hormone in males, other sex steroid hormones (dehydroepiandrosteroneDHEA, androstenedione, dihydrotestosterone, estrogen, and progesterone), peptide hormones (activin, inhibin, and follistatin, which are included in feedback mechanisms and spermatogenesis), production of spermatozoa (sperm cells), and sexual arousal (11, 15)

doi: 10.1097/IN9.0000000000000020 129 AssmannNO'BrienKLDonnellyRPDyckLZaiatz-BittencourtVLoftusRMet al

Understanding this axis helps explain why different secretagogues may produce different effect profiles

Key characteristics of NAION include: Sudden vision loss, often upon waking Permanent damage with no proven treatment to restore vision Increased risk of vision loss in the other eye Significant impact on quality of life, independence, and ability to work For many patients, the NAION-related optic nerve damage is life-altering and irreversible