Hypogonadism is when the sex glands produce little or no hormones. In men, these glands (gonads) are the testes; in women, they are the ovaries.
Male hypogonadism is a condition in which the body does not produce enough testosterone — the hormone that plays a key role in masculine growth and development during puberty or has an impaired ability to produce sperm or both.
Causes of Hypogonadism
- Certain autoimmune disorders
- Genetic and developmental disorders
- Liver and kidney disease
- Certain medications, including steroids and opiates
- Genetic problems
- Nutritional deficiencies
- Iron excess (hemochromatosis)
- Rapid, significant weight loss
Signs and Symptoms of Hypogonadism
Girls who have hypogonadism during childhood will not begin menstruating. The condition can affect girls breast development and height. If hypogonadism occurs after puberty, symptoms include:
- Hot flashes
- Loss of body hair
- Low libido
- Menstruation stops
In boys, hypogonadism in childhood affects muscle and beard development and leads to growth problems. In men the usual symptoms are:
- Breast enlargement
- Decreased beard and body hair
- Muscle loss
- Sexual problems
Treatments of Hypogonadism
- Hormone replacement. For hypogonadism caused by testicular failure, doctors use male hormone replacement therapy (testosterone replacement therapy, or TRT). TRT can restore muscle strength and prevent bone loss. In addition, men receiving TRT may experience an increase in energy, sex drive, erectile function and sense of well-being.
- Assisted reproduction. Although there's often no effective treatment to restore fertility in a man with primary hypogonadism, assisted reproductive technology may be helpful. This technology covers a variety of techniques designed to help couples who have been unsuccessful in achieving conception.
- Radiation therapy, including brachytherapy and proton therapy
Treatment for boys
In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis. Pituitary hormones may be used to stimulate testicle growth. An initial low dose of testosterone with gradual increases may help to avoid adverse effects and more closely mimic the slow increase in testosterone that occurs during puberty.
Several testosterone delivery methods exist. Choosing a specific therapy depends on your preference of a particular delivery system, the side effects and the cost. Methods include:
- Gum and cheek (buccal cavity).
- Implantable pellets. Testosterone-containing pellets (Testopel) are surgically implanted under the skin every three to six months.