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Hypogonadism
This is an abbreviated version of the complete article.*
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| Basic Facts |
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Hypogonadism is a condition in which the body's sex glands do not produce enough hormones. |
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Depending on when hypogonadism occurs, it can cause symptoms such as ambiguous sex organs, delayed puberty, infertility, decreased libido, and osteoporosis. |
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Hypogonadism is typically treated with supplemental hormone therapy. |
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Hypogonadism is a condition in which the body's sex glands or "gonads" (the testes in men and the ovaries in women) do not produce enough hormones. It can occur at any age, from before birth to later adulthood. In males, hypogonadism results in deficiency of the sex hormone testosterone. In females, it results in deficiency of the sex hormone estrogen. Untreated, hypogonadism can result in complications such as infertility and osteoporosis in both men and women.
WHAT ARE THE SYMPTOMS?
The symptoms of hypogonadism depend on when the condition first develops and whether the patient is male or female.
Symptoms in males include:
- Female, ambiguous, or undeveloped genitals;
- Impaired growth of penis and testicles;
- Decrease in size or firmness of testicles;
- Sparse body hair;
- Abnormally long arms and legs;
- Lack of deepened voice;
- Lack of muscle development;
- Breast enlargement;
- Lack of energy;
- Decreased libido;
- Decreased beard and body hair;
- Increase in body fat; and
- Mental and emotional difficulties.
Symptoms in females include:
- Short height;
- Lack of breast development;
- Primary amenorrhea (lack of a first menstrual period);
- Secondary amenorrhea (loss of menstrual periods);
- Low libido;
- Hot flashes; and
- Loss of body hair.
CAUSES AND RISK FACTORS
There are many causes of hypogonadism. Its causes in males can include:
- Klinefelter's syndrome;
- Chemotherapy or radiation treatment;
- Undescended testicles;
- Hemochromatosis;
- Infections such as mumps;
- Injury to the testicles; and
- Normal aging.
In females, primary hypogonadism may be caused by:
- Turner syndrome;
- Other genetic mutations;
- Chemotherapy or radiation treatment;
- Premature menopause; and
- Polycystic ovarian syndrome.
Causes of hypogonadism in both males and females include:
- Central nervous system disorders;
- Pituitary or other types of brain tumors;
- Congenital malformations;
- Radiation treatment;
- Head trauma;
- Inflammatory diseases such as tuberculosis;
- Medications such as opiates;
- HIV/AIDS; and
- Obesity.
Risk factors for hypogonadism include the causes listed above, as well as a family history of the condition.
DIAGNOSIS
Early detection of hypogonadism can help prevent complications of the condition. To diagnose hypogonadism, the physician will conduct a physical exam and perform blood tests to determine levels of testosterone, estrogen, other hormones, and iron. In men, a semen analysis may also be performed. If the physician suspects that the patient has a pituitary or other brain tumor, he or she may recommend a magnetic resonance imaging (MRI) scan of the patient's head.
TREATMENT APPROACH
Hypogonadism is typically treated with supplemental hormone therapy. In boys and men, treatment involves testosterone replacement therapy. Women and girls with hypogonadism are usually treated with estrogen therapy in patch or pill form.
For patients whose hypogonadism has been caused by a brain tumor, the tumor may be removed if possible. Adults with hypogonadism should also consume adequate amounts of calcium and vitamin D, in addition to regular exercise, to help prevent osteoporosis.
Medical Review Date: July 17, 2007
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