Hypogonadism occurs when the gonads produce little or no sex hormones. There are two types: primary, where the problem is in the gonads, and secondary, where the issue is in the brain. Causes include genetic disorders, infections, tumors, and injuries. Symptoms vary between males and females but include impaired sexual development and function. Hormone tests and imaging exams diagnose and identify the cause of low hormone levels. Treatment replaces missing sex hormones through medications, supplements, or hormone therapy tailored to the individual.

1. HYPOGONADISM

2. What is hypogonadism?
Little or no hormone is produced by the testes or ovaries.
Hypogonadism occurs when your sex glands produce little or no sex hormones.
The sex glands, also called gonads, are primarily the testes in men and
the ovaries in women.
Sex hormones help control secondary sex characteristics, such as breast
development in women, testicular development in men, and pubic hair growth.

3. Sex hormones also play a role in the menstrual cycle and sperm production.
Hypogonadism may also be known as gonad deficiency. It may be called low
serum testosterone.
Most cases of this condition respond well to appropriate medical treatment.

4. What are the types of hypogonadism?
There are two types of hypogonadism:
I. primary hypogonadism
II. Secondary hypogonadism

5. Primary hypogonadism
It means that you don’t have enough sex hormones in your
body due to a problem in your gonads.
 Your gonads are still receiving the message to produce
hormones from your brain, but they aren’t able to produce
them.

6. Secondary hypogonadism
In Secondary hypogonadism, the problem lies in your
brain. Your hypothalamus and pituitary gland, which
control your gonads, aren’t working properly.

7. What are the causes of hypogonadism?
The causes of primary hypogonadism include:
Autoimmune disorders, such as Addison’s disease and hypoparathyroidism
Genetic disorders, such as Turner syndrome and Klinefelter syndrome
Severe infections, especially mumps involving your testicles
Liver and kidney diseases
Hemochromatosis, which happens when your body absorbs too much iron
Radiation exposure
Surgery on your sexual organs

8. Secondary Hypogonadism
Genetic disorders, such as abnormal hypothalamic development
Infections, including HIV
Pituitary disorders
Inflammatory diseases, including sarcoidosis, tuberculosis, and
histiocytosis
Obesity
Rapid weight loss

9. Nutritional deficiencies
Use of steroids
Brain surgery
Radiation exposure
Injury to your pituitary gland or hypothalamus
A tumor in or near your pituitary gland

10. What are the symptoms of hypogonadism?
Symptoms that may appear in females include:
lack of menstruation
slow or absent breast growth
hot flashes
loss of body hair
low or absent sex drive
milky discharge from breasts

11. Symptoms that may appear in males include:
Abnormal breast growth, reduced growth of penis and
testicles, erectile dysfunction
Osteoporosis , low or absent sex drive, infertility, fatigue,
difficulty concentrating
loss of body hair, muscle loss

12. How is hypogonadism diagnosed?
Your doctor will conduct a physical exam to confirm that your sexual
development is at the proper level for your age. They may examine
your muscle mass, body hair, and your sexual organs
I. Hormone tests
II. Imaging tests

13. Hormone Tests
If your doctor thinks you might have hypogonadism, they’ll first check 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 tested if you’re female. If you’re male, you’ll
have your testosterone level tested.
These tests are usually 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.

14. Your doctor may order more blood tests to help confirm a diagnosis and rule
out any underlying causes.
Iron levels can affect your sex hormones. For this reason, your doctor may
check for high blood iron levels, typically seen in hemochromatosis.
Your doctor may also wish to measure your prolactin levels. Prolactin is a
hormone that promotes breast development 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.

15. 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.

16. What are the treatments for hypogonadism?
Treatment for female hypogonadism
If you’re female, your treatment will involve increasing your
amount of female sex hormones.
Your first line of treatment will probably be estrogen therapy if
you’ve had a hysterectomy. Either a patch or pill can administer
supplemental estrogen.

17. Because increased estrogen levels can increase your risk
of endometrial cancer, you’ll be given a combination of estrogen and
progesterone if you haven’t had a hysterectomy. Progesterone can
lower your risk for endometrial cancer if you’re taking estrogen.
Other 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.

18. 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
 Injections of a gonadotropin-releasing hormone may trigger puberty or increase
your sperm production.

19. Treatment for hypogonadism in men and women
Treatment for males and females is similar if the
hypogonadism is due to a tumor on the pituitary gland.
Treatment to shrink or remove the tumor may include:
Radiation
Medication
Surgery