Hypogonadism occurs when the body's sex glands produce little or no hormones. In men, these glands (gonads) are the testes. In women, these glands are the ovaries.
The cause of hypogonadism is primary or central. In primary hypogonadism, the ovaries or testes themselves do not function properly. Causes of primary hypogonadism include:
In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Causes of central hypogonadism include:
A genetic cause of central hypogonadism that also takes away the sense of smell is Kallmann syndrome in males. The most common tumors affecting the pituitary are craniopharyngioma in children and prolactinoma in adults.
Girls who have hypogonadism will not begin menstruating. Hypogonadism can affect breast development and height in girls. If hypogonadism occurs after puberty, symptoms include:
In boys, hypogonadism affects muscle and beard development and leads to growth problems. In men the 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 may be prescribed. For girls and women, estrogen and progesterone come in the form of a pill or skin patch. For boys and men, testosterone can be given as a skin patch, skin gel, a solution applied to the armpit, a patch applied to the upper gum, or by injection.
For women who have not had their uterus removed, combination treatment with estrogen and progesterone may decrease the chance of developing endometrial cancer. Women with hypogonadism who have low sex drive may also be prescribed 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). But there is an increased risk of breast cancer and heart disease when hormone therapy is used long-term 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.
Ali O, Donohoue PA. Hypofunction of the testes. In: Kliegman RM, Stanton BF, St. Geme JW III , et al., eds. Nelson Textbook of Pediatrics.19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 577.
Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: An Endocrine Society Clinical Practice guideline. J Clin Endocrinol Metab. 2010;95:2536-2559.
Kansra AR, Donohoue PA. Hypofunction of the ovaries. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 580.
Swerdloff RS, Wang C. The testis and male sexual function. In: Goldman L, Schafer AI. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 242.
Updated by: Nestoras Mathioudakis, MD, Assistant Professor of Medicine, Division of Endocrinology & Metabolism, Johns Hopkins School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.
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