What Is Hypogonadism? Signs, Causes, and How It's Treated
Hypogonadism is a condition where the body produces low levels of testosterone.
It can be due to genetic disorders, injury to the testes, ageing, or pituitary gland diseases.
Symptoms include low libido, fatigue, reduced muscle mass, and mood changes.
Treatment typically involves testosterone replacement therapy.
Testosterone plays a crucial role in male health and vitality.
When levels drop due to Hypogonadism, it can affect both physical and emotional well-being.
This blog will explore what causes Hypogonadism and how to recognize it.
Also, explore the effective treatment options that can help restore your hormonal balance.
What is Hypogonadism?
Hypogonadism is a condition where the body produces too little or no sex hormones due to underactive sex glands (gonads).
In males (testes) and females (ovaries), it helps in producing sex hormones.
These hormones control traits like breast or pubic hair development, sperm production, and menstrual cycles.
Treatment depends on whether fertility is a goal.
In males, it's also called gonadal deficiency and sometimes referred to as andropause or low testosterone.
What are the types of Hypogonadism?
Hypogonadism is of three types: Primary, secondary, and gonadotropic.
We have described each of them below-
Primary Hypogonadism:
This occurs when the gonads can't produce enough sex hormones despite receiving signals from the brain.
A problem in the gonads causes it and is also called hypogonadotropic Hypogonadism.
Secondary Hypogonadism:
The issue starts in the brain, where the hypothalamus or pituitary fails to stimulate the gonads.
It's also known as central Hypogonadism or hypogonadotropic Hypogonadism.
Eugonadotropic Hypogonadism:
The pituitary functions normally in this type, but hormone production is still low.
It affects only females and is linked to ovarian issues like PCOS.
Eugonadotropic Hypogonadism is also called normogonadotropic hypogonadism.
What causes Hypogonadism?
The causes for Primary Hypogonadism are-
Genetic disorders like Klinefelter syndrome and Turner syndrome
Autoimmune diseases such as Hypoparathyroidism and Addison's disease
- Undescended testes
- Mumps or infection of the testicles or ovaries
- Liver or kidney diseases
- Radiation exposure
- Surgery of any sexual organs
The secondary hypogonadism-like condition may appear due to the following issues-
- Genetic disorders like Kallmann syndrome(abnormal hypothalamic development)
- A Tumor in or near the pituitary gland
- Infections, including HIV
- Injury to the hypothalamus or pituitary gland
- Inflammatory diseases such as tuberculosis and sarcoidosis
- Rapid weight loss
- Obesity
- Brain surgery
- Nutritional deficiencies
- Use of opioids or steroids
- Hemochromatosis is a condition that occurs when your body absorbs too much Iron
The causes of Eugonadotropic Hypogonadism include-
- Polycystic ovary syndrome(PCOS)
- Delayed menarche
- Hyperprolactinemia, or having an excess amount of the hormone known as Prolactin
What are the Symptoms of Hypogonadism?
The symptoms that may appear in people with AFAB include-
- Slow or absent breast growth
- Hot flashes
- Lack of menstruation
- Loss of body hair
- Low or absent sex drive
- Milky discharge from the breasts
- Osteoporosis
- Infertility
The symptoms that can occur in people with AMAB include-
- Muscle loss
- Reduced growth of the testicles and penis
- Abnormal breast growth
- Erectile dysfunction
- Fatigue
- Loss of body hair
- Osteoporosis
- Hot flashes
- Infertility
- Difficulty concentrating
- Low or absent sex drive
How is Hypogonadism diagnosed?
A doctor may conduct a physical examination to check your sexual development according to your age.
During inspection, they will check your muscle mass, hair, and sexual organs.
To diagnose Hypogonadism, doctors may order blood tests to measure LH and FSH, hormones from the pituitary gland.
AFAB individuals may be tested for estrogen and AMH to assess egg count.
AMAB individuals will typically have morning testosterone tests and may need a semen analysis to check sperm count.
Additional blood tests may be done to confirm the diagnosis and identify underlying causes.
Other tests include:
Prolactin Test:
Measures prolactin, which supports breast development and milk production in AFAB and is also present in AMAB.
Iron Test:
High iron levels can affect sex hormones so that doctors may check iron levels.
Thyroid Test:
Since thyroid issues can mimic Hypogonadism, thyroid hormone levels are tested to rule out other causes.
Genetic Test:
Used to detect chromosomal disorders like Turner syndrome, which may lead to Hypogonadism.
Imaging Tests:
Ultrasounds check ovaries for issues like cysts or PCOS. MRIs or CT scans may detect pituitary tumours.
What age do men get hypogonadism?
Men can develop hypogonadism at any age, but it most commonly occurs after the age of 40 as testosterone levels naturally begin to decline.
However, younger men can also experience hypogonadism due to factors like genetic conditions, obesity, injuries, infections, or certain medications.
Early-onset hypogonadism may appear during puberty, while age-related (late-onset) hypogonadism generally develops between ages 40 and 60 as testosterone production decreases gradually.
What are the treatments for Hypogonadism for both males and females?
If caused by a pituitary tumour, Hypogonadism is treated similarly across all genders.
A doctor may advise medication, radiation, or surgery to shrink or remove the tumour in this treatment.
The treatments that are generally directed for females or males with hypogonadism are-
Treatment for Female Hypogonadism
Treatment for female Hypogonadism aims to boost sex hormone levels and depends on the type and fertility goals.
For ovarian failure in primary Hypogonadism, options include adoption, egg donation, or a gestational carrier.
For secondary Hypogonadism, FSH or hCG 5000iu injections may trigger ovulation.
Estrogen therapy, via patch or pill, is common.
If you’ve had a hysterectomy, you can use estrogen alone.
If not, estrogen is typically combined with progesterone to reduce endometrial cancer risk.
Other treatments may target symptoms or underlying conditions like PCOS in gonadotropic Hypogonadism.
Treatment for Male Hypogonadism
In male Hypogonadism, GnRH or gonadotropins may help to trigger puberty or boost sperm production.
Sperm harvesting or donation is also an option.
If fertility isn’t a concern, testosterone replacement therapy (TRT) may be recommended.
TRT is available as patches, gels, pellets, injections, or lozenges.
What's the long-term outlook for Hypogonadism?
Hypogonadism is often a lifelong condition unless caused by something treatable.
Stopping hormone therapy can lower sex hormone levels, so that ongoing treatment may be needed.
Most cases respond well to medical treatment.
Support groups or therapy can help manage long-term care.
Final Lines:
Hypogonadism is a chronic condition that often requires ongoing treatment to maintain hormone levels.
Most cases respond well to medical therapy.
Support groups and counselling can help manage the emotional and physical effects in the long term.
Faq
The common causes include genetic Klinefelter syndrome in men and Turner syndrome in women. However, Autoimmune diseases can also increase the risk by damaging the gonads.
Testosterone replacement therapy is the most effective treatment for Hypogonadism. The TRT can help restore sex drive, energy, muscle mass, bone density, and body hair in men.
Hypogonadism is usually chronic unless caused by a treatable condition. Hormone therapy can help manage symptoms, but stopping the treatment often leads to decreased hormone levels again.
Yes, Hypogonadism can affect male physical traits and reproductive function. Early signs include low sex drive, reduced energy, and changes in body composition. If you suspect any of these symptoms, you must consult a doctor.
Chronic stress can disrupt hormone levels and lead to hypogonadotropic Hypogonadism. The condition is more likely to appear if the body is already vulnerable to hormonal imbalance.
Hypogonadism is often permanent and linked to low reproductive hormone levels. It's rarely used to describe infertility without hormone deficiency.
