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Introduction

Hypogonadism may also be known as gonad deficiency. 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.

Male hypogonadism, also known as testosterone deficiency, is a failure of the testes to produce the male sex hormone testosterone, sperm, or both. Testosterone is produced in the testes and is important for the formation of male characteristics such as deepening of the voice, development of facial and pubic hair, and growth of the penis and testes during puberty. 

You may be born with male hypogonadism, or it can develop later in life. Hypogonadism may occur at any age, and the consequences differ, according to when it starts. If hypogonadism occurs before puberty, puberty does not progress. If it occurs after puberty, there may be infertility and sexual dysfunction.

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What are the types of hypogonadism?

There are two types of hypogonadism: 

- 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.

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

What causes male hypogonadism?

Doctors of Garbhagudi IVF Center in Electronic City says hypogonadism in a male refers to a decrease in either or both of the two major functions of the testes: sperm production and testosterone production.

The causes of primary hypogonadism include:

- Autoimmune disorders, such as Addison’s disease and hypoparathyroidism

- Genetic disorders, such as Turner syndrome and Klinefelter syndrome

- Liver and kidney diseases

- Undescended testicle

- Hemochromatosis, which happens when your body absorbs too much iron

- Radiation treatment, chemotherapy, mumps, tumors or trauma to the testes

- Surgery on your sexual organs

The causes of secondary hypogonadism include:

- Genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development)

infections, including HIV

- Pituitary disorders

- Inflammatory diseases, including sarcoidosis, tuberculosis, and histiocytosis

- Morbid obesity

- Malnutrition

- Use of steroids or opioids

- Brain surgery

- Radiation treatments 

- Injury to your pituitary gland or hypothalamus

- A tumor in or near your pituitary gland

- Medication side effects

What are the signs and symptoms of male hypogonadism?

Many IVF doctors in Garbhagudi Ivf Centre in Bangalore says that the signs and symptoms depend on the stage at which the patient presents with hypogonadism in relation to sexual maturity. 

If testosterone deficiency occurs before or during puberty, signs, and symptoms are likely to include:

1. Delayed puberty:

  • lack of development of the testes and lack of growth of the penis

  • lack of public and facial hair

  • failure of the voice to break

  • reduction or absent sperm production in the testes, resulting in infertility.

 2. Delayed bone age 

Around the time of puberty, boys with too little testosterone may also have less than normal strength and endurance, and their arms and legs may continue to grow out of proportion with the rest of their body.

In men who have already reached sexual maturity, symptoms are likely to include:

- Inadequate erections, loss of libido and poor sexual performance

- tiredness

- loss of public and facial hair

- decreased sperm count

- soft, small testes

- mood changes

- increased body fat 

- thinning of the bones (osteoporosis)

- reduced muscle bulk and physical strength

- a wrinkled ‘parchment-like’ appearance of the skin

- increased sweating.  

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How can you treat hypogonadism?

Treatment for male hypogonadism depends on the cause and whether you're concerned about fertility. You can also consult a doctor online and book an appointment for treatment.

- Hormone replacement
For hypogonadism caused by testicular failure, doctors use male hormone replacement therapy (testosterone replacement therapy, or TRT). TRT can restore muscle strength and prevent bone loss.

If a pituitary problem is a cause, pituitary hormones may stimulate sperm production and restore fertility. Testosterone replacement therapy can be used if fertility isn't an issue. A pituitary tumor may require surgical removal, medication, radiation or the replacement of other hormones.

- Assisted reproduction
Although there's often no effective treatment to restore fertility in a man with primary hypogonadism, assisted reproductive technology may be helpful. This technology covers a variety of techniques designed to help couples who have been unsuccessful in achieving conception.