HypogonadismSymptoms, Doctors, Treatments, Advances & More
Learn About Hypogonadism
Hypogonadism occurs when the body's sex glands (gonads) produce little or no hormones. In men, these glands are the testes. In women, these glands are the ovaries.
Gonadal deficiency; Testicular failure; Ovarian failure; Testosterone - hypogonadism
The cause of hypogonadism can be primary (testes or ovaries) or secondary (problem with the pituitary or hypothalamus). In primary hypogonadism, the ovaries or testes themselves do not function properly. Causes of primary hypogonadism include:
- Certain autoimmune disorders
- Genetic and developmental disorders
- Infection
- Iron excess (hemochromatosis)
- Liver and kidney disease
- Radiation (to the gonads)
- Surgery
- Trauma
The most common genetic disorders that cause primary hypogonadism are Turner syndrome (in women) and Klinefelter syndrome (in men).
If you already have other autoimmune disorders you may be at higher risk for autoimmune damage to the gonads. These can include disorders that affect the liver, adrenal glands, and thyroid glands, as well as type 1 diabetes.
In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Causes of central hypogonadism include:
- Anorexia nervosa
- Bleeding in the area of the pituitary
- Taking medicines, such as glucocorticoids and opiates
- Stopping anabolic steroids
- Genetic problems
- Infections
- Nutritional deficiencies
- Iron excess (hemochromatosis)
- Radiation (to the pituitary or hypothalamus)
- Rapid, significant weight loss (including weight loss after bariatric surgery)
- Surgery (skull base surgery near the pituitary)
- Trauma
- Tumors
A genetic cause of central hypogonadism is Kallmann syndrome. Many people with this condition also have a decreased sense of smell.
Menopause is the most common reason for hypogonadism. It is normal in all women and occurs on average around age 50. Testosterone levels decrease in men as they age, as well. The range of normal testosterone in the blood is much lower in a 50 to 60 year-old man than it is in a 20 to 30 year-old man.
Girls who have hypogonadism will not begin menstruating. Hypogonadism can affect their breast development and height. If hypogonadism occurs after puberty, symptoms in women include:
- Hot flashes
- Energy and mood changes
- Menstruation becomes irregular or stops
In boys, hypogonadism affects muscle, beard, genital and voice development. It also leads to growth problems. In men the symptoms are:
- Breast enlargement
- Muscle loss
- Decreased interest in sex (low libido)
If a pituitary or other brain tumor is present (central hypogonadism), there may be:
- Headaches or vision loss
- Milky breast discharge (from a prolactinoma, a tumor that produces the hormone prolactin)
- Symptoms of other hormone deficiencies (such as hypothyroidism)
The most common tumors affecting the pituitary are craniopharyngioma in children and prolactinoma adenomas in adults.
You may need to take hormone-based medicines. Estrogen and progesterone are used for girls and women. The medicines come in the form of a pill or skin patch. Testosterone is used for boys and men. The medicine can be given as a skin patch, skin gel, a solution applied to the armpit, a patch applied to the upper gum, or by injection.
Menopausal symptoms may be treated with estrogen alone (if the woman does not have a uterus) or estrogen and progesterone for a woman who still has a uterus. This is called combination hormone therapy.
In some women, injections or pills can be used to stimulate ovulation. Injections of pituitary hormone may be used to help men produce sperm. Other people may need surgery and radiation therapy if there is a pituitary or hypothalamic cause of the disorder.
Baylor Medicine At McNair - Urology
Larry I. Lipshultz, M.D., is Professor of Urology and Chief of the Scott Department of Urology’s Division of Male Reproductive Medicine and Surgery. Dr. Lipshultz, who holds the Smith Chair in Reproductive Medicine, is a well-known authority on abnormalities of male reproduction, erectile dysfunction, and male hormone production. He received his medical training at the University of Pennsylvania and received fellowship training at the University of Texas at Houston as the first AUA research scholar. Recognized as a leading expert on men’s health, Dr. Lipshultz is a highly respected author and editor, as well as lecturer. Teacher as well as physician, researcher, writer, and editor, Dr. Lipshultz instituted a fellowship training program in male reproductive medicine and surgery that has trained more than 80 physicians who are now in practice both here and abroad. Dr. Lipshultz is rated as an Elite provider by MediFind in the treatment of Hypogonadism. He is also highly rated in 17 other conditions, according to our data. His clinical expertise encompasses Peyronie Disease, Hypogonadism, Infertility, Vasectomy, and Hormone Replacement Therapy (HRT). Dr. Lipshultz is currently accepting new patients.
Baylor Medicine At McNair - Urology
Mohit Khera, M.D., M.B.A., M.P.H., Associate Professor, is the Director of the Laboratory for Andrology Research at McNair Medical Institute, Baylor College of Medicine. He is also the Medical Director of the Executive Health Program at Baylor. Dr. Khera is a Board-certified urologist specializing in male infertility, male and female sexual dysfunction, and declining testosterone levels in aging men. Dr. Khera's research focuses on the efficacy of botulinum toxin type A in treating Peyronie's disease as well as genetic and epigenetic studies on post-finasteride syndrome patients and testosterone replacement therapy. Dr. Khera is rated as an Elite provider by MediFind in the treatment of Hypogonadism. He is also highly rated in 20 other conditions, according to our data. His clinical expertise encompasses Hypogonadism, Peyronie Disease, Erectile Dysfunction (ED), Hormone Replacement Therapy (HRT), and Prostatectomy. Dr. Khera is currently accepting new patients.
SLUCare Physician Group
Dr. Sandeep Dhindsa is an endocrinology specialist who treats conditions that include diabetes, low testosterone, thyroid, pituitary and adrenal disorders. His primary area of research is in the field of hypogonadism and type 2 diabetes. He has shown that one-third of men with diabetes and obesity have low testosterone. He is studying the role of testosterone in insulin resistance and diabetes control. Dr. Dhindsa is a professor in the Department of Internal Medicine and serves as the director of the Division of Endocrinology, Diabetes and Metabolism at Saint Louis University School of Medicine. He is a member of the American Diabetes Association and the Endocrine Society. A fellow of the American Association of Clinical Endocrinologists, Dr. Dhindsa is also a member of the Scientific Reproductive Committee of that organization. Dr. Dhindsa is rated as an Elite provider by MediFind in the treatment of Hypogonadism. He is also highly rated in 10 other conditions, according to our data. His clinical expertise encompasses Hypogonadotropic Hypogonadism, Hypogonadism, Isolated Hypogonadotropic Hypogonadism, Hormone Replacement Therapy (HRT), and Gastric Bypass. Dr. Dhindsa is board certified in American Board Of Internal Medicine/Endocrinology, Diabetes & Metabolism , Drug Enforcement Administration , Missouri Dept Of Health/Narcotics&Dangerous Drugs , and Missouri State Board Of Registration.
Many forms of hypogonadism are treatable and have a good outlook.
In women, hypogonadism may cause infertility. Menopause is a form of hypogonadism that occurs naturally. It can cause hot flashes, vaginal dryness, and irritability as estrogen levels fall. The risk for osteoporosis and heart disease increase after menopause.
Some women with hypogonadism take estrogen therapy, most often those who have early menopause. But long-term use of hormone therapy may increase the risk for breast cancer, blood clots and heart disease (especially in older women). Women should talk with their health care provider about the risks and benefits of menopausal hormone therapy.
In men, hypogonadism results in the loss of sex drive and may cause:
- Impotence
- Infertility
- Osteoporosis
- Weakness
Men normally have lower testosterone as they age. However, the decline in hormone levels is much less than in women.
Contact your provider if you notice:
- Breast discharge
- Breast enlargement (men)
- Hot flashes (women)
- Impotence
- Loss of body hair
- Loss of menstrual period
- Problems getting pregnant
- Problems with your sex drive
- Weakness
Both men and women should contact their provider if they have headaches or vision problems.
Maintaining fitness, normal body weight and healthy eating habits may help in some cases. Other causes may not be preventable.
Summary: The aim of this trial is to evaluate whether testosterone replacement results in greater improvement in pain perception, pain tolerance, sexual function, fatigue, and quality of life when compared with placebo in men with chronic spinal pain treated with opioids who have opioid-induced hypogonadism (low testosterone).
Summary: This is a large randomized, double-blind, placebo-controlled trial to determine the efficacy of testosterone replacement on cancer-related fatigue in older men with solid or hematologic (blood) cancer who report fatigue and have low testosterone levels.
There is no recent research available for this condition. Please check back because thousands of new papers are published every week and we strive to find and display the most recent relevant research as soon as it is available.
Published Date: July 21, 2024
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Cooney CA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 216.
Wierman ME, Arlt W, Basson R, et al. Androgen therapy in women: a reappraisal: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(10):3489-3510. PMID: 25279570 pubmed.ncbi.nlm.nih.gov/25279570/.