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Hypogonadism

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Causes, signs and symptoms of hypogonadism

Hypogonadism is a reduction or absence of hormone secretions from the sex glands (gonads). In men the hormones are secreted from the testes; in women the hormones come from the ovaries. Many types of hypogonadism can be treated and the condition does have a good prognosis.

There are two types of hypogonadism; Primary, where the testes fail to function properly, and Central hypogonadism where the centers of the brain responsible for control of the gonads (the hypothalamus and pituitary) do not function properly.

Causes of primary and central hypogonadism

Primary hypogonadism occurs for a number of different reasons. These include:

  • Surgery

  • Radiation

  • Infection

  • Genetic disorders such as Klinefelter syndrome in men (Turner syndrome in women)

  • Liver disease

  • Kidney disease

  • Autoimmune disorders
  • Central hypogonadism causes include:

  • Bleeding

  • Infection

  • Nutritional deficiencies as seen in anorexia nervosa

  • An excess of Iron called hemochromatosis

  • Genetic abnormalities like Kallman syndrome in men. Men with this condition are unable to smell.

  • Radiation

  • Pituitary tumors called craniopharyngioma in children and prolactinoma in adults

  • Trauma

  • Surgery
  • Signs and Symptoms of hypogondism in boys and men
    Symptoms of hypogonadism will depend to an extent on the cause.
    General symptoms include: Lack of muscle and beard development in boys and growth problems.
    In men symptoms include muscle loss, sexual dysfunction such as a decreased libido, impotence and decreased volume of ejaculate, low serum testosterone levels, weakness, fatigue, breast enlargement, decreased beard and body hair. Cause specific symptoms of hypogonadism may include:
    Tumors, headaches and vision loss
    Pituitary tumors will cause prolactia where men's breasts produce a milky discharge.

    Treatments for hypogonadism
    Treatment will depend on the causes of the problem. Tumors can be treated with surgery and radiotherapy.
    Infection will required antibiotic therapy
    Nutritional causes require cause specific treatments.

    Men may require hormonal medication to replace testosterone by patch or injection. Injections of pituitary hormone may be required for men to produce sperm.

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