Learn About Hypogonadotropic Hypogonadism
Hypogonadism is a condition in which the male testes or the female ovaries produce little or no sex hormones.
Hypogonadotropic hypogonadism (HH) is a form of hypogonadism that is due to a problem with the pituitary gland or hypothalamus.
Gonadotropin deficiency; Secondary hypogonadism
HH is caused by a lack of hormones that normally stimulate the ovaries or testes. These hormones include:
- Gonadotropin-releasing hormone (GnRH)
- Follicle stimulating hormone (FSH)
- Luteinizing hormone (LH)
Normally:
- The hypothalamus in the brain releases GnRH.
- This hormone stimulates the pituitary gland to release FSH and LH.
- These hormones tell the female ovaries or the male testes to release hormones that lead to normal sexual development in puberty, normal menstrual cycles, estrogen levels and fertility in adult women, and normal testosterone production and sperm production in adult men.
- Any change in this hormone release chain causes a lack of sex hormones. This prevents normal sexual maturity in children and normal function of the testicles or ovaries in adults.
There are several causes of HH:
- Damage to the pituitary gland or hypothalamus from surgery, injury, tumor, infection, or radiation
- Genetic variants
- High doses or long-term use of opioid or steroid (glucocorticoid) medicines
- High prolactin level (a different hormone released by the pituitary)
- Severe stress
- Nutritional problems (both rapid weight gain or weight loss)
- Long-term (chronic) medical diseases, including chronic inflammation or infections
- Drug use, such as heroin or use or abuse of prescription opioid medicines
- Certain medical conditions, such as iron overload
Kallmann syndrome is an inherited form of HH. Some people with this condition also lose their sense of smell (anosmia).
Children:
- Lack of growth and sexual development at the usual age for puberty (development may be very late or incomplete)
- In girls, a lack of breast development and menstrual periods
- In boys, no development of sex characteristics, such as enlargement of the testes and penis, deepening of the voice, and facial hair
- Inability to smell (in some cases)
- Short stature (in some cases)
Adults:
- Loss of interest in sex (libido) in men
- Loss of menstrual periods (amenorrhea) in women
- Decreased energy and interest in activities
- Loss of muscle mass in men
- Weight gain
- Mood changes
- Infertility
Treatment depends on the source of the problem, but may involve:
- Injections of testosterone (in males)
- Slow-release testosterone skin patch (in males)
- Testosterone gels (in males)
- Estrogen and progesterone pills or skin patches (in females)
- GnRH injections
- HCG injections
Penn Endocrinology Perelman
Peter Snyder is an Endocrinologist in Philadelphia, Pennsylvania. Dr. Snyder is rated as an Elite provider by MediFind in the treatment of Hypogonadotropic Hypogonadism. His top areas of expertise are Isolated Hypogonadotropic Hypogonadism, Hypogonadotropic Hypogonadism, Hypogonadism, Pituitary Tumor, and Hormone Replacement Therapy (HRT). Dr. Snyder is currently accepting new patients.
Brigham And Women's Hospital
Ursula Kaiser is an Endocrinologist in Boston, Massachusetts. Dr. Kaiser is rated as an Elite provider by MediFind in the treatment of Hypogonadotropic Hypogonadism. Her top areas of expertise are Precocious Puberty, Hypogonadotropic Hypogonadism, Hypogonadism, Pituitary Tumor, and Orchiectomy.
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 Hypogonadotropic Hypogonadism. His top areas of expertise are Hypogonadism, Peyronie Disease, Erectile Dysfunction (ED), Hormone Replacement Therapy (HRT), and Prostatectomy.
The right hormone treatment will cause puberty to start in children and may restore fertility in adults. If the condition begins after puberty or in adulthood, symptoms will often improve with treatment.
Health problems that may result from HH include:
- Delayed puberty
- Early menopause (in females)
- Infertility
- Low bone density and fractures later in life
- Low self-esteem due to late start of puberty (emotional support may be helpful)
- Sexual problems, such as low libido
Contact your provider if:
- Your child does not start puberty at the appropriate time.
- You are a woman under age 40 and your menstrual cycles stop.
- You have lost armpit or pubic hair.
- You are a man and you have decreased interest in sex.
Background: \- During puberty, children begin to develop into adults. Problems with the hormones released during puberty can affect the reproductive system. Some people have low hormone levels that severely delay or prevent puberty. Others start puberty abnormally early. Other people may have a normal puberty but develop reproductive disorders later in life. Researchers want to study people with reproductive ...
Summary: The purpose of this study is to to build a registry of women with early estrogen loss due to Functional Hypothalamic Amenorrhea (FHA) to understand the prevalence, racial and ethnic diversity of this condition.
Published Date: July 13, 2025
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.
Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID: 29562364 pubmed.ncbi.nlm.nih.gov/29562364/.
Kaiser U, Ho KKY. Pituitary physiology and diagnostic evaluation. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 6.
Pitteloud N, Papadakis GE, Jacobs AN. Physiology and disorders of puberty. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 23.
White PC. Sexual development. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 220.