Learn About Hypogonadotropic Hypogonadism

What is the definition of 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.

Save information for later
Sign Up
What are the alternative names for Hypogonadotropic Hypogonadism?

Gonadotropin deficiency; Secondary hypogonadism

What are the causes of Hypogonadotropic 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) and luteinizing hormone (LH).


  • 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 defects
  • 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 opiate medicines
  • Certain medical conditions, such as iron overload

Kallmann syndrome is an inherited form of HH. Some people with this condition also have anosmia (loss of the sense of smell).

What are the symptoms of Hypogonadotropic Hypogonadism?


  • Lack of growth and sexual development at the standard 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)


  • 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
Not sure about your diagnosis?
Check Your Symptoms
What are the current treatments for Hypogonadotropic Hypogonadism?

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
Who are the top Hypogonadotropic Hypogonadism Local Doctors?
Learn about our expert tiers
Learn more
What is the outlook (prognosis) for Hypogonadotropic Hypogonadism?

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.

What are the possible complications of Hypogonadotropic Hypogonadism?

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
When should I contact a medical professional for Hypogonadotropic Hypogonadism?

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.
Endocrine glands
The pituitary gland
What are the latest Hypogonadotropic Hypogonadism Clinical Trials?
The Role of Gonadotropin Pulsations in the Regulation of Puberty and Fertility

Background: - The body produces gonadotropin-releasing hormone (GnRH) about every 2 hours. GnRH travels through the bloodstream to the pituitary gland, where it stimulates the gland to produce hormones called gonadotropins. These hormones stimulate the testicles or ovaries. The testicles produce testosterone and develop sperm. The ovaries produce estrogen and prepare for ovulation. Normal estrogen and testost...

Match to trials
Find the right clinical trials for you in under a minute
Get started
Kisspeptin Administration Subcutaneously to Patients With Reproductive Disorders

Summary: The investigators are recruiting women with hypothalamic amenorrhea or Idiopathic Hypogonadotropic Hypogonadism. Kisspeptin will be administered subcutaneously (SC) for 2-weeks in a pulsatile fashion. Ultrasound monitoring of ovarian follicular growth and frequent blood sampling (q10 min for up to 2hr) will be performed to assess the physiologic response to kisspeptin over time.

What are the Latest Advances for Hypogonadotropic Hypogonadism?
Recovery of hypothalamic-pituitary-gonadal function with low dose testosterone treatment in a male with congenital hypogonadotropic hypogonadism.
Hypogonadism in adolescent girls: treatment and long-term effects.
Tired of the same old research?
Check Latest Advances
Improvement of Bone Health and Initiation of Puberty Development in Camurati-Engelmann Disease With Glucocorticoid and Losartan Treatment: A Case Report and Review of Literature.
Who are the sources who wrote this article ?

Published Date: July 28, 2021
Published By: Brent Wisse, MD, Board Certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

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/.

Styne DM. Physiology and disorders of puberty. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 26.

White PC. Sexual development and identity. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 220.