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.
The cause of hypogonadism may be "primary" or "central." In primary hypogonadism, the ovaries or testes themselves do not function properly. Some causes of primary hypogonadism include:
In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Some causes of central hypogonadism include:
A genetic cause of central hypogonadism that also takes away the sense of smell is Kallmann syndrome (males). The most common tumors affecting the pituitary are craniopharyngioma (in children) and prolactinoma (in adults).
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:
In boys, hypogonadism in childhood affects muscle and beard development and leads to growth problems. In men the usual symptoms are:
If a brain tumor is present (central hypogonadism), there may be:
Tests may be done that check:
Other tests may include:
Hormone-based medicines are available for men and women. Estrogen comes in the form of a patch or pill. Testosterone can be given using a patch, a product soaked in by the gums, a gel, or by injection.
For women who have not had their uterus removed, combination treatment with estrogen and progesterone is often recommended to decrease the chances of developing endometrial cancer. Women with hypogonadism who have a low sex drive can also take low-dose testosterone.
In some women, injections or pills can be used to stimulate ovulation. Injections of pituitary hormone may be used to help male patients produce sperm. Other people may need surgery and radiation therapy.
Many forms of hypogonadism are treatable and have a good outlook.
In women, hypogonadism may cause infertility. Menopause is a form of hypogonadism that occurs naturally and can cause hot flashes, vaginal dryness, and irritability as a woman's estrogen levels fall. The risk of osteoporosis and heart disease increase after menopause.
Some women with hypogonadism take estrogen therapy especially those who have early menopause (premature ovarian failure). However, there is a small but significant increase in risk for breast cancer and possibly heart disease when hormone therapy is used to treat menopause symptoms.
In men, hypogonadism results in loss of sex drive and may cause:
Men normally have lower testosterone as they age, but the decline is not as dramatic or steep as the decline in sex hormones that women experience.
Talk to your doctor if you notice:
Both men and women should call their health care provider if they have headaches or vision problems.
Maintain normal body weight and healthy eating habits to prevent anorexia nervosa. Other causes may not be preventable.
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Faiman C. Male hypogonadism. Cleveland Clinic: Current Clinical Medicine. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2010:pgs 397-401.