Hypogonadism, in a male, refers to a decrease in either testosterone production, sperm production, or both. The medical professionals at our clinic address the testosterone aspect of this condition. TRT therapy is one of the key ways to have a positive impact on sperm production as well.

What is hypogonadism?

Hypogonadism occurs when your sex glands produce little or no sex hormones. The sex glands, also called gonads, are primarily the testes in men and the ovaries in women. Sex hormones help control secondary sex characteristics, such as breast development in women, testicular development in men, and pubic hair growth. Sex hormones also play a role in the menstrual cycle and sperm production.

Hypogonadism may also be known as gonad deficiency. It may be called low serum testosterone or andropause when it happens in males.

Most cases of this condition respond well to appropriate medical treatment.

What are the types of hypogonadism?

There are two types of hypogonadism: primary and central.

Primary hypogonadism

Primary hypogonadism means that you don’t have enough sex hormones in your body due to a problem in your gonads. Your gonads are still receiving the message to produce hormones from your brain, but they aren’t able to produce them.

Central (secondary) hypogonadism

In central hypogonadism, the problem lies in your brain. Your hypothalamus and pituitary gland, which control your gonads, aren’t working properly.

What are the causes of hypogonadism?

The causes of primary hypogonadism include:

  • autoimmune disorders, such as Addison’s disease and hypoparathyroidism;
  • genetic disorders, such as Turner syndrome and Klinefelter syndrome;
  • severe infections, especially mumps involving your testicles;
  • liver and kidney diseases;
  • undescended testes;
  • hemochromatosis, which happens when your body absorbs too much iron;
  • radiation exposure;
  • surgery on your sexual organs.

Central hypogonadism may be due to:

  • genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development);
  • infections, including HIV;
  • pituitary disorders;
  • inflammatory diseases, including sarcoidosis, tuberculosis, and histiocytosis;
  • obesity;
  • rapid weight loss;
  • nutritional deficiencies;
  • use of steroids or opioids;
  • brain surgery;
  • radiation exposure;
  • injury to your pituitary gland or hypothalamus;
  • a tumor in or near your pituitary gland.

What are the symptoms of hypogonadism?

Symptoms that may appear in females include:

  • lack of menstruation;
  • slow or absent breast growth;
  • hot flashes;
  • loss of body hair;
  • low or absent sex drive;
  • milky discharge from breasts.

Symptoms that may appear in males include:

  • loss of body hair;
  • muscle loss;
  • abnormal breast growth;
  • reduced growth of penis and testicles;
  • erectile dysfunction;
  • osteoporosis;
  • low or absent sex drive;
  • infertility;
  • fatigue;
  • hot flashes;
  • difficulty concentrating.

How is hypogonadism diagnosed?

A thyroid specialist will conduct a physical exam to confirm that your sexual development is at the proper level for your age. They may examine your muscle mass, body hair, and your sexual organs.

Hormone tests

If a doctor thinks you might have hypogonadism, they’ll first check your sex hormone levels. You’ll need a blood test to check your level of follicle-stimulating hormone (FSH) and luteinizing hormone. Your pituitary gland makes these reproductive hormones.

You’ll have your estrogen level tested if you’re female. If you’re male, you’ll have your testosterone level tested. These tests are usually drawn in the morning when your hormone levels are highest. If you’re male, a thyroid specialist may also order a semen analysis to check your sperm count. Hypogonadism can reduce your sperm count.

A doctor may order more blood tests to help confirm a diagnosis and rule out any underlying causes.

Iron levels can affect your sex hormones. For this reason, a thyroid specialist may check for high blood iron levels, typically seen in hemochromatosis.

A doctor may also wish to measure your prolactin levels. Prolactin is a hormone that promotes breast development and breast milk production in women, but it’s present in both genders.

A thyroid specialist may also check your thyroid hormone levels. Thyroid problems can cause symptoms similar to hypogonadism.

Imaging tests

Imaging tests can also be useful in diagnosis. An ultrasound uses sound waves to create an image of the ovaries and check for any problems, including ovarian cysts and polycystic ovary syndrome.

A doctor may order MRIs or CT scans to check for tumors in your pituitary gland.

We offer the lab evaluation to determine the signs of hypogonadism and prescribe the TRT treatment if required. For any additional questions concerning the lab work, therapies, or prescriptions, please get in touch with us here.