What is hypogonadism?

Hypogonadism is a medical condition characterized by poor functioning of the reproductive organs (gonads) ovaries in the females and testes in the males resulting into deficiency of production of sex hormones namely estrogen and progesterone in females and testosterone in males. Hypogonadism may lead to number of problems common to both males and females and some defects specific in males and females.

Based upon the underlying causes hypogonadism can be primary or central. In primary hypogonadism the defect lies in the gonads whereas in central hypogonadism function of the regulatory organs like pituitary and hypothalamus is compromised. Replacement of the deficient hormone is the principal mode of therapy.

Symptoms of Hypogonadism

Some symptoms of hypogonadism are common to both males and females and include delayed or poor pubertal development, sometimes these changes may completely be absent, lack of interest in sexual activities (loss of libido), inability to reproduce due to poor sperm count in males and lack of ovulation in females (infertility), depression, anxiety, irritability, tiredness, disturbed sleep, inability to concentrate and poor memory, diarrhea, generalized body pain, drying of skin, brittle nails.

There may be poor development of secondary sexual characteristics like lack of growth of hair in the pubic and underarm area, increased body fat, bones become brittle leading to increased tendency of fracture following minimal trauma, abnormal metabolism of blood glucose leading to early onset diabetes and impaired metabolism of fatty substances leading to raised cholesterol and triglyceride level.

Some of the symptoms exclusively occur in males like poor muscle growth of the body even atrophy may occur, poor growth of body and facial hair, poor development of reproductive organs like penis and testes, erectile dysfunction, lack of deepening of voice, frequent episodes of urination and breast development like females (gynecomastia).

Common symptoms of hypogonadism in females include irregular even absence of menstrual bleeding, poor development of breast, features of masculinization like excess growth of facial hair, loss of scalp hair (alopecia) and severe acne.

Causes of Hypogonadism

The hypothalamus is the principal organ that controls release of different hormones from the pituitary gland, hormones released from the pituitary gland in turn stimulates individual glands in the body to produce specific hormones. It produces gonadotrophin-releasing hormone (GnRH) indirectly stimulates the gonads through the pituitary hormones. In males the gonadal organ (testes) produces testosterone and in females the ovaries produce estrogen and progesterone.

These sex hormones (estrogen, progesterone and testosterone) are essential for development of primary and secondary sexual characteristics. Hypogonadism can be classified as primary or central or secondary. In case of primary hypogonadism the defect lies in the gonads whereas in secondary hypogonadism hypothalamus and or the pituitary are not functioning properly. Again based upon the time of onset hypogonadism can be congenital (present since birth) as in patients of Turner’s syndrome and klinefelter syndrome and acquired following mumps, brain injury in childhood, intake of certain drugs like opioids, anabolic steroids and radiation.

Hypogonadism Treatment

Replacement of the deficient hormone is the mainstay of treatment in hypogonadism. Testosterone replacement is done in males where as estrogen and progesterone replacement is done in females.


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