Hypogonadism is a medical condition in which your gonads i.e. sex glands produce very little or no sex hormones. These gonads, known as testes in males and ovaries in females are paired. The main sex hormone in females is estrogen and, in the male, it is testosterone. These hormones are responsible for the attainment of puberty, reproduction and also control secondary sexual characteristics in both males and females like breast development, pattern hair growth, different distribution of body weight.
There are two types of hypogonadism based on the fact that the defect can be either present in the functioning of the brain or in the gonads itself
Primary hypogonadism: The problem lies in the gonads and it means that your gonads don’t produce enough sex hormones despite being signaled by the brain to produce them. It is more common than the other types.
Central hypogonadism: as already mentioned, the problem lies in your brain. Hypothalamus and pituitary are two glands that are part of your brain which controls the functioning of all the major glands of the body including gonads. So defective functioning in the factors secreted by these glands which stimulate the gonads to secrete the sex hormones can lead to this type of hypogonadism. This condition is rare by the way.
There are many causes which are specific to the type of hypogonadism as
Causes of primary hypogonadism
Causes of central hypogonadism
As males and females have different reproductive behavior therefore there some symptoms differ as
Major symptoms of females include
Major symptoms in males include
Your doctor will use your medical history, conduct a physical examination and order some tests to establish a diagnosis.
Medical history: basically, your doctor will ask you questions about your symptoms, problems, family history, and past treatment or surgery.
Physical examination: your doctor will examine your body from head to toe to look for
Imaging tests like ultrasonography can be used to look for the problems in the ovaries and MRI or CT scan to check for the tumors.
Your doctor can order additional tests on the basis of the result of the above tests
The main goals of the treatment are to develop secondary sexual characteristics, preserving muscle bone mass and to psychologically adjust with the society and it includes
Hormone replacement therapy
For females: these include administration of increasing concentrations of female sex hormones and includes estrogen, progesterone or FSH. Estrogen with progesterone will help in the development of secondary sexual characteristics. Estrogen is given alone increases the risk of endometrial carcinoma. FSH will help in triggering the ovulation
For males: the testosterone is the male sex hormone and it can be given in the form of injection, patches or gel. Suitable hormones can be given to the patient depending upon his condition as GnRH agonists can be given to trigger the puberty
Surgery: it can be used to remove the tumor if that tumor is near to the pituitary gland and causing hypogonadism.
Almost all patients have to take hormones for the whole of their lives. The patient suffering from abnormal gonadal development remains unfertile despite being treatment though the secondary sexual characteristics are improved. Many patients have a good outlook.