Hypogonadism happens when sex glands produce small or no sex hormones. The sex glands, also known as gonads, are essentially testes in men and ovaries in women.  The effect of loss of the male sex hormone testosterone. It can lead to loss of sex drive and function, delayed puberty, osteoporosis.

However, sex hormones help control secondary sex characteristics, such as breast development in women, testicular growth in men, and pubic hair growth. Sex hormones can also play a role in sperm production and the menstrual cycle.

Hypogonadism may also be called low serum testosterone or andropause when it occurs in men.

The types of hypogonadism based on science

There are two types of hypogonadism: 

Primary hypogonadism

Primary hypogonadism implies that you don’t have adequate sex hormones in your body due to difficulty in your gonads. Your gonads are, however, getting the message to produce hormones from your brain, though they aren’t able to produce them.

 Secondary (Central) hypogonadism

In central hypogonadism, the difficulty lies in your brain. Your hypothalamus and pituitary gland, which regulate your gonads, aren’t working well.

Causes of hypogonadism

The causes of primary hypogonadism include:

  • genetic disorders, such as Turner syndrome and Klinefelter syndrome
  • severe infections, especially mumps involving your testicles
  • liver and kidney diseases
  • autoimmune disorders, such as Addison’s disease and hypoparathyroidism
  • undescended testes
  • surgery on your sexual organs
  • hemochromatosis, which happens when your body absorbs too much iron
  • radiation exposure

Central hypogonadism may be due to:

  • infections, including HIV
  • pituitary disorders
  • inflammatory diseases, including sarcoidosis, tuberculosis, and histiocytosis
  • obesity
  • rapid weight loss
  • genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development)
  • nutritional deficiencies
  • use of steroids or opioids
  • brain surgery
  • a tumor in or near your pituitary gland
  • radiation exposure
  • injury to your pituitary gland or hypothalamus

Symptoms that may appear in females include:

Symptoms that may appear in males include:

How can hypogonadism be diagnosed

The doctor will conduct a physical exam to prove that your sexual growth is at the proper level for your age. They may check your muscle mass, your sexual organs, and body hair.

Hormone tests

If the doctor assumes you might have hypogonadism, they’ll first review your sex hormone levels. You’ll need a blood test to check your level of follicle-stimulating hormone (FSH) and luteinizing hormone. Your pituitary gland makes these reproductive hormones.

You’ll have your estrogen level examined if you’re female. If you’re male, you’ll have your testosterone level tested. These tests are normally drawn in the morning when your hormone levels are highest. If you’re male, your doctor may also order a semen analysis to check your sperm count. Hypogonadism can reduce your sperm count.

Your doctor may order more blood tests to help confirm a diagnosis and rule out any underlying causes.

Additionally, iron can affect sex hormones. For this purpose, your doctor may check for high blood iron levels, typically seen in hemochromatosis.

Your doctor may also want to measure your prolactin levels. Prolactin is a hormone that helps breast growth and breast milk production in women, but it’s present in both genders.

Your doctor may also check your thyroid hormone levels. Thyroid problems can cause symptoms similar to hypogonadism.

Imaging tests

Imaging tests can also be useful in diagnosis. An ultrasound uses sound waves to create an image of the ovaries and check for any problems, including ovarian cysts and polycystic ovary syndrome.

Your doctor may order MRIs or CT scans to check for tumors in your pituitary gland.

The treatments for hypogonadism

Treatment for female hypogonadism

The treatment for females involves increasing the number of female sex hormones.

Your first line of therapy will probably be estrogen therapy if you’ve had a hysterectomy unless a patch or pill can administer supplemental estrogen.

However, increased estrogen levels can raise your risk of endometrial cancer; you’ll be given a mixture of estrogen and progesterone if you haven’t had a hysterectomy. Progesterone can lower your risk for endometrial cancer if you’re taking estrogen.

Additional treatments can target specific symptoms. If you have a decreased sex drive, you may receive low doses of testosterone. If you have menstrual irregularities or trouble conceiving, you may receive injections of the hormone human choriogonadotropin or pills containing FSH to trigger ovulation.

Treatment for male hypogonadism

Testosterone is a male sex hormone. Testosterone replacement therapy is a widely used treatment for hypogonadism in males. You can get testosterone replacement therapy by:

  • injection
  • patch
  • gel
  • lozenge

Injections of a gonadotropin-releasing hormone may trigger puberty or increase your sperm production.