Hypogonadism
Hypogonadism is a condition in which the body either doesn’t produce enough testosterone or sperm, or both.
A patient may be born with hypogonadism or develop it later in life. Hypogonadism can be primary or secondary.
Causes of Hypogonadism
Causes of primary hypogonadism include:
- A congenital disorder called Klinefelter Syndrome
- Injury to the testicles
- Radiation therapy or chemotherapy
- Undescended testicles
- Anabolic steroid abuse
Causes of secondary hypogonadism include:
- The aging process
- Obesity
- Some medications
- Disorders of the pituitary gland
- Kallman syndrome, a congenital disorder of the hypothalamus
- HIV/AIDS
Symptoms
The symptoms of hypogonadism vary depending on when the patient develops the condition. In congenital hypogonadism, the patient will be born with abnormal genitalia; they can be underdeveloped or ambiguous. Some patients are even born with female genitalia.
If the patient develops hypogonadism in adolescence, the condition may delay puberty or impair their development. In this case, the patient may show symptoms such as gynecomastia or development of breast tissue, little development of muscle mass, impaired growth of male genitals, impaired growth of body hair, excessive growth of the limbs in proportion to the body, and no deepening of the voice.
An adult who develops hypogonadism may symptoms such as decreased muscle mass, gynecomastia, osteoporosis, infertility, erectile dysfunction, and loss of body and facial hair.
Some men may also experience symptoms similar to those of women undergoing menopause like hot flashes, fatigue, trouble concentrating, and decreased sex drive.
Treatment Options
The doctor will start by testing the patient’s testosterone levels. If they are indeed low, the doctor will perform a variety of other tests to try to determine the cause.
The most common treatment for hypogonadism in teenagers and men is some form of testosterone replacement therapy (TRT). The treatment will stimulate puberty in boys and restore muscle mass, energy, sexual function, and a greater sense of well-being in men.
There are many ways to administer TRT. Testosterone can cause liver damage if taken orally for a long time, but it can be safely injected or administered topically. The patient can rub a gel on their skin or wear patches at night. They can also pump a gel up their nose or keep a putty laced with testosterone near their gum line. The doctor may also decide to implant testosterone-administering pellets under the patient’s skin.
Some men will also want fertility treatments. A patient with secondary hypogonadism may be given medications to stimulate their testicles’ production of testosterone and sperm. Such drugs don’t work for patients with primary hypogonadism, so these patients may need to consider methods like in vitro (test tube baby) fertilization.
Patients born with conditions like undescended testicles or underdeveloped or ambiguous genitalia need surgery to correct the problem.