Hypogonadism: Causes, Types, Symptoms, And More

Medically reviewed by G. Liakeas, MD FACT CHECKED

Also referred to as gonad deficiency, hypogonadism could be a critical condition in different people whose bodies do not produce enough sex hormones.

So if you are one of them and want to learn what is hypogonadism, what are its causes, and how you could treat it, then this is the right post you have come across.

All about hypogonadism

Hypogonadism is a condition under which the sex glands may not be able to produce enough sex hormones. 

So, you may have a low sex drive because your sex glands called the gonads are not producing enough hormones. This condition could affect different teenagers and adults irrespective of their gender.

In males, it may result in low testosterone levels, whereas in females it could result in low estrogen levels. If this condition occurs in teenagers, then it might affect them during late puberty.

Before learning in detail about the condition of hypogonadism, let us know about the sex glands and sex hormones. 

The sex glands, namely the testes in males, and the ovaries in females are responsible for the production of hormones.

In males, the testes or the testicles produce the main male hormone, referred to as testosterone. Due to the same reason, if hypogonadism occurs in males, then the major cause behind this is low testosterone levels.

On the other hand, when hypogonadism occurs in females, then it is because of the lower or no production of female hormones like estrogen, testosterone, and progesterone.

What Are The Causes Of Hypogonadism?

You could have hypogonadism either as hypogonadotropic hypogonadism or as hypogonadotropic hypogonadism.

For the former condition, the major reason behind hypogonadism is that your gonads might fail.

On the other hand, the latter condition could result due to the failure in your hypothalamic luteinizing hormone-releasing (LHRH) hormone.

Other than this, the latter could also occur because your pituitary gland may not respond to the follicle-stimulating hormone and the luteinizing hormone secretions.

You may have different causes based on the particular type of hypogonadism. In case you have hypogonadotropic hypogonadism, then it could result from different causes mentioned below.

  • Some of the major causes of hypogonadotropic hypogonadism relate to genetic causes, like the Kallmann syndrome. Moreover, people who have this genetic disease might even have a decreased sense of smell.
  • Sometimes acquired disorders could also lead to hypogonadotropic hypogonadism. These disorders could include Type 2 diabetes mellitus, hyperprolactinemia, Cushing syndrome, acquired immunodeficiency syndrome, human immunodeficiency virus, or exercise-induced hypogonadism.
  • Different disorders relating to your central nervous system, like tumors or issues related to the hypothalamic and pituitary area might also result in this type of hypogonadism.
  • Other vivid causes of hypogonadotropic hypogonadism include different congenital disorders like Gaucher disease, Prader-Willi syndrome, etc.

Besides hypogonadotropic hypogonadism, there are certain causes of hypogonadotropic hypogonadism as well. These causes are segregated based on whether this condition occurs in males or females.

The different causes of hypogonadotropic hypogonadism in females could include premature menopause, Turner syndrome, chemotherapy, Noonan syndrome, resistant ovary, inactivating mutations, etc.

On the other hand. the causes of hypogonadotropic hypogonadism in males could include radiation therapy, inactivating mutation, chemotherapy, defects in testicular determination, LH resistance, or other disorders of sex development.

If you have any of these conditions, then you may be at amplified risk of hypogonadism.

What Are The Types Of Hypogonadism?

The types of hypogonadism are segregated based on the cause of this condition. Generally, there are two types of hypogonadism, namely secondary hypogonadism and primary hypogonadism.

Before understanding these types of hypogonadism, let us understand the anatomy behind the production of hormones.

The process of hormone production in your body is carried out only when the two glands in your brain, namely the pituitary and the hypothalamus gland tell the sex glands to do so.

However, when you have hypogonadism, then in this condition both these glands in your brain may not send signals to your sex glands to make the hormones.

 Based on this condition, let’s know about the different types of hypogonadism.

Primary Hypogonadism

First of all, primary hypogonadism occurs when there is an issue with your sex glands because they either stop or slow down hormone production.

In this condition, though your sex glands are receiving the signal from the brain, there is an issue with them and hence they do not produce enough hormones.

Secondary Hypogonadism

On the other hand, secondary or central hypogonadism could occur when there is an issue with the brain signals that initiate the process of hormone production.

So this could happen when your pituitary gland and the hypothalamus do not function properly.

What Are The Different Symptoms Of Hypogonadism?

The symptoms of hypogonadism primarily depend on your gender, as well as the cause behind your hypogonadism.

The symptoms that could appear in females suffering from hypogonadism could include

  • Low sex drive
  • Milky discharge from the breasts
  • Low growth of the breasts
  • Hot flashes
  • Loss of body hair, and abnormal menstrual cycles.

The symptoms of hypogonadism in males could include

  • Infertility due to lower testosterone levels and low sperm count
  • Erectile dysfunction
  • Loss of muscle
  • Enlarged breasts also referred to as gynecomastia,
  • Reduced growth of the testicles and penis
  • Osteoporosis
  • Difficulty in concentrating
  • Fatigue and hot flashes.

Diagnosis Of Hypogonadism

There are different tests and procedures which your healthcare provider may perform to assess and diagnose hypogonadism.

First of all, your healthcare provider will analyze your symptoms and conduct a physical examination.

He or she may even conduct a pelvic exam for the females. Other than this, you may have to undergo different tests like imaging tests, hormone tests, blood tests, or analysis of your semen.

  1. Imaging Tests

    Different imaging tests like CT scans or MRI could help to identify any areas of problem in your pituitary gland of the brain.

    Other than this, the doctor may even use ultrasound, which could help to analyze any issues like polycystic ovary syndrome.

  2. Blood Or Hormone Tests

    Since hypogonadism occurs when your sex hormone levels are quite low, your doctor will perform certain hormone tests to diagnose this condition.

    For this, your healthcare provider will take a blood test to check the different levels of sex hormones in your body, like prolactin, thyroid hormones, or iron.

    The reason behind checking the iron levels is that these levels could also affect the levels of your sex hormones.

    In case you are a female, then your healthcare provider will check your estrogen levels. On the other hand, if you are a male then he will take your testosterone levels.

    Generally, blood or hormone tests are conducted right in the morning when the level of hormones in your body is at its highest.

  3. Semen Analysis

    In case you are a male and you have hypogonadism, then your healthcare provider could also measure your sperm count to know whether it is low or not.

     This is because hypogonadism could significantly reduce this count.

    Other tests which could even help to diagnose hypogonadism include thyroid tests, genetic tests, or prolactin level tests.

    Thus, once hypogonadism is diagnosed with any of these techniques, your healthcare provider will aim at treating it.

Treatment Of Hypogonadism

The treatment of hypogonadism majorly depends on the cause of this condition. In case you have primary hypogonadism, then it might be treated with hormone replacement therapy, which could help to raise the hormone levels.

Hormone replacement therapy aims at increasing the testosterone levels in males while increasing the estrogen and progesterone levels in females.

These therapies and treatments are available in different forms like shorts, gels, implants, pills, or even skin patches. However, female hormone therapy poses certain risks of blood clots, stroke, cancer, or uterine cancer.

On the other hand, if you have secondary hypogonadism that is caused due to a problem with your pituitary gland, then the treatment for the males and females is similar.

These treatments could include radiation therapy, medications, or surgery. Surgery could be the last resort in case the nonoperative measures are not beneficial.

Potential Complications Of Hypogonadism.

In case you leave your hypogonadism untreated then it could result in certain potential risks and complications. These risks are more for women as compared to men.

This is generally because a man could have low testosterone levels when they age and hence the side effects are not so severe. On the other hand, if you’re a female, then hypogonadism could even cause infertility.

Other than this, other complications of hypogonadism in females could include vaginal dryness, menopause, hot flashes, and irritability when your estrogen levels drastically reduce.

On the other hand, you could even have an amplified risk for heart disease and osteoporosis if you experience menopause.

Many times women undergo estrogen therapy as a treatment for hypogonadism which could have a long-term risk for blood clots, heart disease, and breast cancer.

So you must weigh the benefits of this therapy along with its risks. Moreover, Hypogonadism could even lead to certain other side effects in males, like loss of sex drive, osteoporosis, weakness, impotence, and infertility.

Let Us Wrap It Up

Thus, this was all you need to know about hypogonadism. It is crucial to address this condition as soon as possible because low sex hormones could negatively affect both your mental as well as physical health.

Apart from this, if left untreated then it could also pose certain irreversible side effects to your body.

Some of the tips which you could follow to prevent hypogonadism could include following a healthy eating regime, maintaining normal body weight, and being fit.

However, following these tips does not vouch for the fact that you may not have hypogonadism because other causes of hypogonadism are not preventable.

So if you are opting for hypogonadism treatment, then we wish you good luck!

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