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Hypogonadism Types, Causes, Treatment, And More


The human body may be host to many ailments. Certain diseases and conditions mess up the normal functioning of the body.

One such condition is hypogonadism. To know more in detail, follow up on this article till the end.

What Is Hypogonadism?

Hypogonadism is a condition [1]in which the sex organs fail to produce enough sex hormones. Sometimes there are no hormones at all.

In males, the sex organ [2] testes produce a little amount of testosterone or no testosterone at all. In their counterparts, females, the sex organ ovaries fail to produce enough estrogen.

This hormone production could be almost negligible in some cases. In some cases, the initial problems start in the brain.

Thus your gonads i.e sex organs fail to produce hormones in the right amount. This condition is curable under some circumstances.

However, the cause of this condition should be a curable one. Otherwise, this condition is chronic. It might take a lifetime for treatment and to recover.

It necessarily doesn’t mean that something went wrong on the inside. Sometimes an external injury to your organs might be the reason.

Types Of Hypogonadism

As we have already discussed, hypogonadism may be a fault of your sex organs or your brain. Therefore, it is not difficult to identify the types[3].

  • Primary Hypogonadism

    In this type, the problem [4] lies with your sex organs. Testes in males and ovaries in females fail to produce testosterone and estrogen respectively.

    Your brain performs its job well of signaling the organs to produce hormones. However, they fail to do so.

  • Secondary Hypogonadism

    It is also known as central hypogonadism. Hypothalamus and pituitary glands are unable to control gonads. Therefore, the message [2] is not sent to your organs to produce sex hormones.

    It is also known as central hypogonadism. Hypothalamus and pituitary glands are unable to control gonads. Therefore, the message is not sent to your organs to produce sex hormones.

What Is The Role Of These Hormones? 

As the name suggests, sex hormones are crucial for normal sex drive. These are the initial reasons for changes in puberty.

Changes in men through[5] testosterone

  • Growth of facial and pubic hair
  • Deep voice
  • Testicular development
  • Sperm production
  • Libido
  • Muscle Mass Strength

Similarly, changes in women through[6] estrogen

  • Breast development
  • Regulation of menstrual cycle
  • Healthy development of the reproductive tract
  • Libido

Hypogonadism hinders[7] the development of secondary sexual characteristics. It could shatter your confidence. Your body might not grow as it should normally.

Small breasts and irregular periods are reported by females. Likewise, scanty to no beard and small penis may be observed in males.

Another aspect to consider is physical pleasure. Romance and intimacy with your partner are also a way to happiness. Unfulfilled physical needs may lead to unwanted tensions.

Hypogonadism might exactly do that. Since little to no hormones are produced, sex drive decreases over time. You might become uninterested in making love to your partner.

This may count as a lack of interest and dissatisfaction from their end. From body mass to fat distribution and your voice to libido, sex hormones handle it all. 

Therefore, adequate production of these hormones is essential.

Analyzing the risk of hypogonadism

The lack of hormones itself is concerning. The impact is not just limited to self-confidence and libido.

Your body might become a host to many problems due to hypogonadism such as

The risk associated[11] with males are

  • Erectile dysfunction
  • Low libido
  • Development of breast
  • Low muscle mass and bone mass
  • Infertility
  • Premature death in old aged men

The risk associated with females are

Stages Of Hypogonadism And Symptoms

Hypogonadism is not an age-specific condition. It may target and trigger almost anytime during the life run. There are three main stages divided based on time.

The symptoms for each stage might have visible differences. However, the impact on a healthy lifestyle is almost equally disturbing.

  • By Birth
    It could be inherited genetically by the offspring. In this stage, due to a lack of testosterone, the proper fetal development of the male child is affected.

    As a result, he might be born with female genitals. It is also possible to develop a blend of both i.e. ambiguous genitals.

    In case the baby has male genitals, it won’t be fully developed. Similarly in females, the characteristics of normal female infants are lacking.

  • Puberty
    This phase has a longer window to fall prey to hypogonadism. After puberty, from young days to old age everything comes under this phase.

    So, it has a higher expectancy phase. You are likely to suffer from low libido, lack of energy, infertility, and even depression as a symptom.

    If it takes a serious turn, you will likely experience emotional turmoil and mental instability. Hot flashes and difficulty concentrating are other possible impacts.

The study[14] mentions how you could manage hypogonadism at every stage, from birth to puberty.

The Causes Of Hypogonadism

The causes of hypogonadism are many. They might be different for primary and secondary hypogonadism.

Let’s discuss the possible [7] causes of primary hypogonadism in both males and females.

  1. For Males

    • Autoimmune Disorders
      Two common disorders that are related to hormonal imbalance are Addison’s disease and hyperparathyroidism. These may affect both men and women.

      However, women are likely to get affected more. Addison’s disease hinders adrenal gland hormone production.
      Hypoparathyroidism lowers the level of the parathyroid hormone leading to hypogonadism, as per this study[15].
      The study[16] has shown that untreated medical conditions like rheumatic autoimmune disease also contribute to hypogonadism.

    • Sexual Organ Surgery
      Surgeries performed on genitals lead to alterations. It may increase the risk of hypogonadism.
    • Injury
      Injuries to sex organs are most likely to affect hormone production. Hence, it may cause hypogonadism.
    • Hemochromatosis
      It is a condition[17] in which too much iron is present in the blood. This affects testicular function and the pituitary gland in males.
      Women might experience fatigue and joint pain. They are more likely to suffer from hemochromatosis after[18] menopause.
    • Liver And Kidney Diseases
      Chronic liver and kidney diseases affect[9] normal hormone production. In both males, serum testosterone lowers due to these diseases.
      In women, high luteinizing hormone might trigger the same issues.
    • Galactosemia And Fragile X Syndrome
      The inability to process[19] sugar galactose is galactosemia. Mild disabilities like shaky hands, balance problems, etc are a part of fragile X syndrome.
    • Cancer Treatment
      During chemotherapy, radiation exposure might lead[20] to hypogonadism. It may even lead to infertility.
    • Klinefelter syndrome
      The male body has two chromosomes X and Y. This Y chromosome is specifically present just in males. In Klinefelter syndrome an additional X chromosome is present.
      It makes a total of three chromosomes namely X, Y, and X. This extra X affects normal testicular development. Thus, it lowers[21] testosterone levels.
    • Mumps Orchitis
      These mumps target testicles. This problem advances among teens or adults. It may damage your testicles. It may hamper[22] testosterone production.
    • Undescended Testes
      Testes are inside before birth. Later, they descend to the scrotum. In some cases, one or both testicles do not descend after birth.
      This condition may disappear during childhood. The study[23] concludes that this condition could increase the risk of hypogonadism if left untreated.
  2. For Females

    • Turner Syndrome
      In this case, females have only one X chromosome. This may lead[24] to infertility, skin conditions, and the absence of secondary sexual characteristics.
    • Ovarian Dysgenesis
      It is a condition of abnormal[25] reproduction organ growth and can occur in both men and women.
    • Agenesis
      The organs are unable[26] to develop during embryonic development.

Causes Of Secondary Hypogonadism

The following could[7] be the secondary causes of hypogonadism- 

  1. Obesity– It is a common factor that leads not just to hypogonadism but more. Overweight individuals usually have hormone fluctuations.
  2. Chronic Diseases– Some long-term diseases that may cause hypogonadism are diabetes, renal disease, and anorexia.
  3. Sarcoidosis– It is a multisystem disease. Its characteristics are granulomas in several organs.
  4. Infections– Infections like TB and meningitis might cause hypogonadism. Others could be fungal and bacterial infections.
  5. Pituitary Apoplexy– A term used for bleeding of the pituitary gland.
  6. Kallman’s Syndrome– An impaired sense of smell combined with hormonal imbalance is Kallman’s syndrome. It may delay or prevent puberty.
  7. Hyperprolactinemia– High production of a hormone called prolactin.
  8. Intracranial Space-Occupying Lesions– These lesions may be tumors or cysts.
  9. Other Reasons– These could be trauma, medications, malnourishment, infections, and the use of steroids.

Test And Treatment Of Hypogonadism

Firstly, a physical examination is conducted. If the development of the body is not normal, the doctor will recommend hormone tests.

These tests may involve [27] blood tests to check for luteinizing hormone and follicle-stimulating hormone. If you are a female, your estrogen level is checked.

For males, testosterone level is tested. The semen test is specifically for males to check sperm count. Once hormones are checked, tests are conducted to check for causes.

Such tests may involve checking prolactin or iron levels. Imaging tests could be done to check ovarian cysts in females. Other tests are MRI and CT scans.

For treatment, both males and females are given hormone replacement therapy[28]. It is done to supplement hormones lacking in the body.

Females are generally given a mix of estrogen and progesterone to eliminate cancer risk.

Males are supplemented with testosterone by injection, gels, or patches. In case of tumor-related hypogonadism, radiation, surgery, and medications are given.


Hypogonadism is a condition in which enough sex hormones are not produced. It is found in both males and females. It is usually a chronic condition that requires lifelong treatment.

Treatment helps increase hormone levels. However, stopping treatment midway might decrease hormonal levels.


Working4Health prefers using primary and verified references. We have strict sourcing guidelines and our primary references include peer-reviewed research, academic, and medical institution studies.

  1. Hypogonadism. Date of Publication: 8/29/2020. Available from: https://medlineplus.gov/ency/article/001195.htm
  2. Peeyush Kumar, Nitish Kumar, Devendra Singh Thakur, et. al. Male hypogonadism: Symptoms and treatment. J Adv Pharm Technol Res. 2010 Jul-Sep; 1(3): 297301.doi: 10.4103/0110-5558.72420
  3. Angela Richard-Eaglin. Male and Female Hypogonadism. Nurs Clin North Am. 2018 Sep;53(3):395-405. doi: 10.1016/j.cnur.2018.04.006. Available from: https://pubmed.ncbi.nlm.nih.gov/30100005/
  4. Micol S Rothman, Margaret E Wierman. Female hypogonadism: evaluation of the hypothalamic-pituitary-ovarian axis. Pituitary. 2008;11(2):163-9. doi: 10.1007/s11102-008-0109-3. Available from: https://pubmed.ncbi.nlm.nih.gov/18404388/
  5. Understanding How Testosterone Affects Men September 23, 2013 Available from: https://www.nih.gov/news-events/nih-research-matters/understanding-how-testosterone-affects-men
  6. Benjamin J. Delgado; Wilfredo Lopez-Ojeda. Estrogen Last Update: June 28, 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538260/
  7. Omeed Sizar; Janice Schwartz. Treasure Island (FL): StatPearls Publishing. Hypogonadism. Availablw from: https://www.ncbi.nlm.nih.gov/books/NBK532933/
  8. Wenshan Lv, Na Du, Ying Liu, et al. Low Testosterone Level and Risk of Alzheimer’s Disease in the Elderly Men: a Systematic Review and Meta-Analysis Mol Neurobiol. 2016 May;53(4):2679-84. doi: 10.1007/s12035-015-9315-y. Epub 2015 Jul 8. Available from: https://pubmed.ncbi.nlm.nih.gov/26154489/
  9. Nannan Thirumavalavan, Nathan A Wilken, Ranjith Ramasamy Hypogonadism and renal failure: An update Indian J Urol. 2015 Apr-Jun;31(2):89-93. doi: 10.4103/0970-1591.154297. Available from: https://pubmed.ncbi.nlm.nih.gov/25878406/
  10. A L Vertkin, L Iu Morgunov, Kh A Shakhmanaev [Hypogonadism and chronic obstructive pulmonary disease] Urologiia
    . 2013 Sep-Oct;(5):116-8, 120-2. Available from: https://pubmed.ncbi.nlm.nih.gov/24437255/
  11. Huanguang Jia, Charles T Sullivan, Sean C McCoy, et al. Review of health risks of low testosterone and testosterone administration World J Clin Cases. 2015 Apr 16; 3(4): 338–344.Published online 2015 Apr 16. doi: 10.12998/wjcc.v3.i4.338
  12. Michael T. Sheehan Polycystic Ovarian Syndrome: Diagnosis and Management Clin Med Res. 2004 Feb; 2(1): 13–27.
    doi: 10.3121/cmr.2.1.13
  13. Mehmet Nuri Özbek, Hüseyin Demirbilek, Rıza Taner Baran, et al. Bone Mineral Density in Adolescent Girls with Hypogonadotropic and Hypergonadotropic Hypogonadism J Clin Res Pediatr Endocrinol. 2016 Jun; 8(2): 163–169.
    Published online 2016 Jun 6. doi: 10.4274/jcrpe.2228
  14. Sasha R Howard, Leo Dunkel Management of hypogonadism from birth to adolescence Best Pract Res Clin Endocrinol Metab. 2018 Aug;32(4):355-372. doi: 10.1016/j.beem.2018.05.011. Epub 2018 Jun 6. Available from: https://pubmed.ncbi.nlm.nih.gov/30086863/
  15. Robert Krysiak, Bogusław Okopień [Hypoparathyroidism and hypogonadism as a clinical manifestation of hemochromatosis] Przegl Lek. 2013;70(1):35-7. Available from: https://pubmed.ncbi.nlm.nih.gov/23789304/
  16. Jacques Baillargeon, Soham Al Snih, Mukaila A Raji, et al. Hypogonadism and the risk of rheumatic autoimmune disease Clin Rheumatol. 2016 Dec;35(12):2983-2987. doi: 10.1007/s10067-016-3330-x. Epub 2016 Jun 20. Available from: https://pubmed.ncbi.nlm.nih.gov/27325124/
  17. J H McDermott, C H Walsh Hypogonadism in hereditary hemochromatosis J Clin Endocrinol Metab. 2005 Apr;90(4):2451-5. doi: 10.1210/jc.2004-0980. Epub 2005 Jan 18. Available from: https://pubmed.ncbi.nlm.nih.gov/15657376/
  18. Hereditary hemochromatosis Last updated February 1, 2019 Available from: https://medlineplus.gov/genetics/condition/hereditary-hemochromatosis/
  19. Fragile X syndrome Last updated April 1, 2020 Available from: https://medlineplus.gov/genetics/condition/fragile-x-syndrome/
  20. Basil O. Burney and Jose M. Garcia Hypogonadism in male cancer patients J Cachexia Sarcopenia Muscle. 2012 Sep; 3(3): 149–155.Published online 2012 Apr 20. doi: 10.1007/s13539-012-0065-7
  21. Christian Høst, Anne Skakkebæk, Kristian A Groth, et al. The role of hypogonadism in Klinefelter syndrome Asian J Androl. 2014 Mar-Apr;16(2):185-91. doi: 10.4103/1008-682X.122201. Available from: https://pubmed.ncbi.nlm.nih.gov/24407186/
  22. Ronan Le Goffic, Thomas Mouchel, Annick Ruffault, et al. Mumps Virus Decreases Testosterone Production and Gamma Interferon-Induced Protein 10 Secretion by Human Leydig Cells J Virol. 2003 Mar; 77(5): 3297–3300.doi: 10.1128/JVI.77.5.3297-3300.2003
  23. Julia Rohayem, Alessandra Luberto, Eberhard Nieschlag, et al. Delayed treatment of undescended testes may promote hypogonadism and infertility Endocrine. 2017 Mar;55(3):914-924. doi: 10.1007/s12020-016-1178-0. Epub 2017 Jan 9. Available from: https://pubmed.ncbi.nlm.nih.gov/28070708/
  24. Aneta Gawlik, Magdalena Hankus, Kamila Such, et al. Hypogonadism and Sex Steroid Replacement Therapy in Girls with Turner Syndrome J Pediatr Adolesc Gynecol. 2016 Dec;29(6):542-550. doi: 10.1016/j.jpag.2016.03.005. Epub 2016 Mar 25. Available from: https://pubmed.ncbi.nlm.nih.gov/27018757/
  25. Ovarian dysgenesis 1 Available from: https://www.ncbi.nlm.nih.gov/gtr/conditions/C0949595/
  26. Santosh Kumar Jha, Rosina Manandhar, and Veena Rani Shrivastava Coexistence of Gonadal Dysgenesis and Mullerian Agenesis in a Female with 46,XX Karyotype: A Case Report JNMA J Nepal Med Assoc. 2019 Apr; 57(216): 119–122.
    Published online 2019 Apr 30. doi: 10.31729/jnma.4287
  27. Vidhya Viswanathan, MD and Erica A. Eugster, MD. Etiology and Treatment of Hypogonadism in Adolescents. Pediatr Clin North Am. 2011 Oct; 58(5): 1181–x. doi: 10.1016/j.pcl.2011.07.009
  28. Arthi Thirumalai, Kathryn E. Berkseth, and John K. Amorya. Treatment of Hypogonadism: Current and Future Therapies. Version 1. F1000Res. 2017; 6: 68. Published online 2017 Jan 23. doi: 10.12688/f1000research.10102.1

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