Hypogonadism in a man is a condition in which there is a decrease in one or both of the major functions of the testes, namely sperm production, and testosterone production. There are two types of hypogonadism - the primary hypogonadism and secondary hypogonadism. In secondary hypogonadism, the defect doesn’t lie in your sex glands or gonads. They lie in the brain. On the other hand, having Primary hypogonadism means you don’t have enough sex hormones in your body due to problems in your gonads( sex glands). Although the sex glands are receiving messages from the brain to produce enough sex hormones, they are unable to do so.

Also, in primary hypogonadism also known as hypogonadotropic hypogonadism, it is common for the pituitary gland to try and stimulate the testes to produce more testosterone by releasing too much luteinizing hormone (LH) and follicle-stimulating hormone (FSH) hormones. Thus in most patients suffering from primary hypogonadism, testosterone levels may be low or normal with high levels of FSH and LH.

Here are some common symptoms of hypogonadism :

  • Erectile dysfunction
  • Low sperm count
  • Low libido
  • Depressed mood
  • Lethargy
  • Sleep disturbances
  • Loss of body hair
  • Decreased muscle and mass strength
  • Infertility
  • Hot flashes
  • Reduced growth of penis and testicles

Whether you are suffering from hypogonadism or not can easily be detected by your doctor by a physical examination and some blood tests. In the physical examination, the doctor checks your muscle mass, body hair, and sexual organs.  The blood tests usually involve checking for the levels of your FSH and LH. He may also measure your prolactin levels, thyroid hormone levels, and iron levels.  The other studies which are usually done include semen analysis, pituitary imaging, genetic studies, and testicular biopsy.

Primary hypogonadism can happen for a number of reasons like :

1 Genetic disorders like Turner syndrome and Klinefelter syndrome.

2 Autoimmune disorders like Addison’s disease and hypothyroidism

3 Liver and kidney diseases

4 Severe infections, including mumps affecting your testicles

5 Hemochromatosis, a condition in which the body absorbs too much iron leading to testicular failure or pituitary gland dysfunction.

6 Injury to the testicles, which they are prone to since they are outside the abdomen. Although damage to one testicle might not prevent the total testosterone production, this might definitely lead to reduced production of testosterone.

7 Undescended testicles, a condition present at birth where one or both testicles aren’t descended during birth. Usually, although this condition gets corrected in the first few years of life without treatment or medical intervention, if not then it leads to malfunction of testicles and low testosterone.

8 Cancer treatment including radiation, which interferes with testosterone and sperm production. Although the effects are often temporary, it might lead to permanent infertility.

So what are the possible treatments for primary hypogonadism? Testosterone replacement therapy (TRT) is widely used for treating this. Since oral forms of testosterone replacement are usually not used due to high risk of side effects, it is mostly used in the injectable, patch and gel forms. But the good news is that TRT can eliminate if not all, then most of the symptoms of male hypogonadism! So if you think you might be suffering from hypogonadism, it’s best to consult your doctor, right away.