2. Hypogonadism
means diminished functional activity of the gonads—
the testes or the ovaries —that may result in
diminished sex hormone biosynthesis.
Low androgen (e.g., testosterone) levels are referred to
as hypoandrogenism and low estrogen (e.g., estradiol)
as hypoestrogenism, and may occur as symptoms of
hypogonadism.
3. TYPES
There are two types of hypogonadism: primary and
central.
Primary hypogonadism
Primary hypogonadism 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.
Central (secondary) hypogonadism
In central hypogonadism, the problem lies in your
brain. Your hypothalamus and pituitary gland, which
control your gonads, aren’t working properly.
4. CAUSES
Too much iron in the blood can
cause testicular failure or pituitary gland dysfunction,
affecting testosterone production. Injury to the
testicles. Because they're situated outside the
abdomen, the testicles are prone to injury. Damage to
normally developed testicles can cause hypogonadism.
5. CAUSES ACCORDING TO TYPE
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
undescended testes
hemochromatosis, which happens when your body
absorbs too much iron
radiation exposure
surgery on your sexual organs
6. Central hypogonadism may be due to:
genetic disorders, such as Kallmann syndrome (abnormal
hypothalamic development)
infections, including HIV
pituitary disorders
inflammatory diseases, including sarcoidosis, tuberculosis,
and histiocytosis
obesity
rapid weight loss
nutritional deficiencies
use of steroids or opioids
brain surgery
radiation exposure
injury to your pituitary gland or hypothalamus
a tumor in or near your pituitary gland
7. Signs and symptoms
Women with hypogonadism do not
begin menstruating and it may affect their height and
breast development. Onset in women after puberty
causes cessation of menstruation, lowered libido, loss
of body hair and hot flashes. In boys it causes
impaired muscle and beard development and reduced
height. In men it can cause reduced body hair and
beard, enlarged breasts, loss of muscle, and sexual
difficulties. A brain tumor (central hypogonadism)
may involve headaches, impaired vision, milky
discharge from the breast and symptoms caused by
other hormone problems.
8.
9.
10. Key points
Hypogonadism may occur at any age, and the
consequences differ, according to when it starts.
If hypogonadism occurs before puberty, puberty does
not progress. If it occurs after puberty, there may
be infertility and sexual dysfunction.
In adult men, symptoms begin within a few weeks of
the onset of testosterone deficiency.
Hypogonadism may increase the risk for
cardiovascular disease, type 2 diabetes, metabolic
syndrome, premature death in older men,
and Alzheimer's disease.
12. TREATMENT
Testosterone replacement therapy
Commonly used testosterone replacement therapies
include transdermal (through the skin) using a patch
or gel, injections, or pellets.
Another treatment for hypogonadism is human
chorionic gonadotropin (hCG). This stimulates the LH
receptor, thereby promoting testosterone synthesis.
