BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuHypogonadismGonadal deficiency; Testicular failure; Ovarian failure; Testosterone - hypogonadismHypogonadism 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. Causes The cause of hypogonadism can be primary (testes or ovaries) or secondary (problem with the pituitary or hypothalamus). In primary hypogonadism, the ovaries or testes themselves do not function properly. Causes of primary hypogonadism include:Certain autoimmune disorders Autoimmune disordersAn autoimmune disorder occurs when the body's immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of aut...ImageRead Article Now Book Mark Article Genetic and developmental disorders Infection Liver and kidney disease Radiation (to the gonads) Surgery TraumaThe most common genetic disorders that cause primary hypogonadism are Turner syndrome (in women) and Klinefelter syndrome (in men).Turner syndromeTurner syndrome is a rare genetic condition in which a female does not have the usual pair of X chromosomes.ImageRead Article Now Book Mark Article Klinefelter syndromeKlinefelter syndrome is a genetic condition that occurs in males when they have an extra X chromosome.ImageRead Article Now Book Mark Article If you already have other autoimmune disorders you may be at higher risk for autoimmune damage to the gonads. These can include disorders that affect the liver, adrenal glands, and thyroid glands, as well as type 1 diabetes.In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Causes of central hypogonadism include:Anorexia nervosa Bleeding in the area of the pituitary Taking medicines, such as glucocorticoids and opiates Stopping anabolic steroids Genetic problems Infections Nutritional deficiencies Iron excess (hemochromatosis) HemochromatosisHemochromatosis is a condition in which there is too much iron in the body. It is also called iron overload.ImageRead Article Now Book Mark Article Radiation (to the pituitary or hypothalamus) Rapid, significant weight loss (including weight loss after bariatric surgery) Surgery (skull base surgery near the pituitary) Trauma Tumors A genetic cause of central hypogonadism is Kallmann syndrome. Many people with this condition also have a decreased sense of smell.Kallmann syndromeHypogonadism is a condition in which the male testes or the female ovaries produce little or no sex hormones. Hypogonadotropic hypogonadism (HH) is a...ImageRead Article Now Book Mark Article Menopause is the most common reason for hypogonadism. It is normal in all women and occurs on average around age 50. Testosterone levels decrease in men as they age, as well. The range of normal testosterone in the blood is much lower in a 50 to 60 year-old man than it is in a 20 to 30 year-old man. Symptoms Girls who have hypogonadism will not begin menstruating. Hypogonadism can affect their breast development and height. If hypogonadism occurs after puberty, symptoms in women include:Hot flashes Energy and mood changes Menstruation becomes irregular or stops In boys, hypogonadism affects muscle, beard, genital and voice development. It also leads to growth problems. In men the symptoms are:Breast enlargement Muscle loss Decreased interest in sex (low libido) If a pituitary or other brain tumor is present (central hypogonadism), there may be:Headaches or vision loss Milky breast discharge (from a prolactinoma) Symptoms of other hormonal deficiencies (such as hypothyroidism) HypothyroidismHypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. This condition is often called underactive thyroid....ImageRead Article Now Book Mark Article The most common tumors affecting the pituitary are craniopharyngioma in children and prolactinoma adenomas in adults. Exams and Tests You may need to have tests to check: Estrogen level (women) Follicle stimulating hormone (FSH level) and luteinizing hormone (LH) level FSH levelThe follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH is a hormone released by the pituitary gland, located on t...Read Article Now Book Mark Article LH) levelThe LH blood test measures the amount of luteinizing hormone (LH) in blood. LH is a hormone released by the pituitary gland, located on the undersid...Read Article Now Book Mark Article Testosterone level (men) - interpretation of this test in older men and men who are obese can be difficult so results should be discussed with a hormone specialist (endocrinologist) Testosterone levelA testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. The test described...Read Article Now Book Mark Article Other measures of pituitary functionOther tests may include:Blood tests for anemia and iron AnemiaAnemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. Different type...ImageRead Article Now Book Mark Article Genetic tests including a karyotype to check chromosomal structure Prolactin level (milk hormone) Prolactin levelProlactin is a hormone released by the pituitary gland. The prolactin test measures the amount of prolactin in the blood.Read Article Now Book Mark Article Sperm count Sperm countSemen analysis measures the amount and quality of a man's semen and sperm. Semen is the thick, white fluid released during ejaculation that contains...ImageRead Article Now Book Mark Article Thyroid tests Sometimes imaging tests are needed, such as a sonogram of the ovaries. If pituitary disease is suspected, an MRI or CT scan of the brain may be done.SonogramUltrasound uses high-frequency sound waves to make images of organs and structures inside the body.ImageRead Article Now Book Mark Article MRIA head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...ImageRead Article Now Book Mark Article CT scan of the brainA head computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.ImageRead Article Now Book Mark Article Treatment You may need to take hormone-based medicines. Estrogen and progesterone are used for girls and women. The medicines come in the form of a pill or skin patch. Testosterone is used for boys and men. The medicine 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 or another male hormone called dehydroepiandrosterone (DHEA).Endometrial cancerEndometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).ImageRead Article Now Book Mark Article In some women, injections or pills can be used to stimulate ovulation. Injections of pituitary hormone may be used to help men produce sperm. Other people may need surgery and radiation therapy if there is a pituitary or hypothalamic cause of the disorder. Outlook (Prognosis) Many forms of hypogonadism are treatable and have a good outlook. Possible Complications In women, hypogonadism may cause infertility. Menopause is a form of hypogonadism that occurs naturally. It can cause hot flashes, vaginal dryness, and irritability as estrogen levels fall. The risk for osteoporosis and heart disease increase after menopause.InfertilityInfertility means you cannot get pregnant (conceive). There are 2 types of infertility:Primary infertility refers to couples who have not become preg...ImageRead Article Now Book Mark Article OsteoporosisOsteoporosis is a disease in which bones become fragile and more likely to break (fracture).ImageRead Article Now Book Mark Article Heart diseaseCoronary heart disease is a narrowing of the small blood vessels that supply blood and oxygen to the heart. Coronary heart disease (CHD) is also cal...ImageRead Article Now Book Mark Article Some women with hypogonadism take estrogen therapy, most often those who have early menopause. But long-term use of hormone therapy may increase the risk for breast cancer, blood clots and heart disease (especially in older women). Women should talk with their health care provider about the risks and benefits of menopausal hormone therapy.Estrogen therapyHormone therapy (HT) uses one or more hormones to treat symptoms of menopause. HT uses estrogen, progestin (a type of progesterone), or both. Somet...Read Article Now Book Mark Article In men, hypogonadism results in loss of sex drive and may cause:Impotence Infertility Osteoporosis Weakness Men normally have lower testosterone as they age. However, the decline in hormone levels is not as dramatic as it is in women. When to Contact a Medical Professional Talk to your provider if you notice:Breast discharge Breast enlargement (men) Hot flashes (women) Impotence Loss of body hair Loss of menstrual period Problems getting pregnant Problems with your sex drive WeaknessBoth men and women should call their provider if they have headaches or vision problems. Prevention Maintaining fitness, normal body weight and healthy eating habits may help in some cases. Other causes may not be preventable.Open ReferencesReferencesAli O, Donohoue PA. Hypofunction of the testes. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 601.Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID: 29562364 pubmed.ncbi.nlm.nih.gov/29562364/.Styne DM. Physiology and disorders of puberty. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 26.Swerdloff RS, Wang C. The testis and male hypogonadism, infertility, and sexual dysfunction. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 221.van den Beld AW, Lamberts SWJ. Endocrinology and aging. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 28.AllVideoImagesTogGonadotropins - illustration The pituitary gland controls the release of several hormones, including the gonadotropins FSH (follicle-stimulating hormone) and LH (luteinizing hormone). FSH and LH in turn control the release of sex hormones (testosterone, estrogen, and progesterone). In children, these hormones govern the onset of puberty and sexual development. After puberty and during adulthood, they control reproductive function.GonadotropinsillustrationGonadotropins - illustration The pituitary gland controls the release of several hormones, including the gonadotropins FSH (follicle-stimulating hormone) and LH (luteinizing hormone). FSH and LH in turn control the release of sex hormones (testosterone, estrogen, and progesterone). In children, these hormones govern the onset of puberty and sexual development. After puberty and during adulthood, they control reproductive function.GonadotropinsillustrationRelated Information Turner syndrome(Condition)Klinefelter syndrome(Condition)Hypogonadotropic hypogonadism(Condition)Craniopharyngioma(Condition)Prolactinoma(Condition)Infertility(Condition)Osteoporosis(Condition)Infertility in women(In-Depth)Osteoporosis(In-Depth)Menopause(In-Depth) Review Date: 8/29/2020 Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. 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