Everything You Need to Know About Male Hypogonadism 

Male hypogonadism occurs when the male body fails to produce enough testosterone, sperm or both. Here are some helpful info about the condition.

Hypogonadism affects both males and females, but it affects males at a much larger rate than it does females. Boston University School of Medicine estimates that four to five million US men have the condition. Some males are born with the condition or develop it during puberty. More often, though, the condition develops in adulthood. Infection or injury is the most common cause of the condition in older men. The symptoms for males depend on the age at which the condition occurs. Treatment depends mostly on the cause of the condition.

Two Types of Hypogonadism

The primary type of hypogonadism stems from a problem with the testicles. The secondary type occurs when there’s a problem with the pituitary gland or the hypothalamus. Both the pituitary gland and the hypothalamus are parts of the brain, and they signal the release of hormones that tell the testicles when to make testosterone.

Both types of the condition can develop at birth or in adulthood. It’s also possible to have the primary and secondary types at the same time.

Increased Risk

Several biological conditions increase a male’s chance of developing this condition.

Three of the most common biological causes are:

1. Chemotherapy or Radiation –

Cancer treatment often affects the body’s ability to produce testosterone and sperm. Although the effects are usually temporary, permanent infertility is possible. Some men undergoing cancer treatment choose to preserve their sperm before starting therapy.

2. Testicle Trauma –

Any physical damage to the testicles can hinder testosterone production. The testicles are outside the body, so they are at risk for injury. Physical activities, such as sports, are the most common reason for testicle trauma.

3. Congenital Abnormality –

Klinefelter syndrome is an abnormality of the X and Y sex chromosomes. Most males have an X and a Y chromosome. But a man with this syndrome has additional X chromosomes along with the Y. The additional X chromosome negatively affects testicle development.

The secondary form of the condition also has several possible causes.

Four of the most common causes of secondary are:

1. Aging –

As men get older, they usually produce less testosterone. The decrease is slow but continuous.

2. AIDS/HIV –

AIDS/HIV can affect the hypothalamus, the pituitary gland and the testes. A problem with one or more of these can decrease testosterone production.

3. Brain Tumor –

A tumor on or near the pituitary gland can cause a testosterone deficiency. Treatment for the tumor can also hinder pituitary function.

4. Certain Disease –

Inflammatory diseases that affect the hypothalamus and pituitary gland often hinder testosterone production. Tuberculosis is an example of one such disease. Research also suggests that obesity is a risk factor.

Symptoms

Symptoms depend on when the condition develops. If it occurs in the womb, then it affects the male baby’s genitals. The genitals may be underdeveloped, appear ambiguous or appear as female genitals. The condition can also delay puberty or prevent normal development.

Adult males may experience impaired reproduction and mental changes. Symptoms can include:
1. Osteoporosis
2. Development of breasts
3. Infertility
4. Impotence
5. Hot flashes
6. Fatigue
7. Decreased sex drive
8. Inability to concentrate

Diagnosis, Treatment and Risks

A physical exam and blood tests are required for a diagnosis. Testosterone replacement is usually the suggested treatment. This therapy can restore the sex drive, increase energy and prevent erectile dysfunction. In the case of a pituitary problem, pituitary hormones can restore fertility and sperm production. There isn’t a treatment that guarantees to repair infertility caused by testicle problems.

The Mayo Clinic reports that boys also undergo testosterone replacement therapy. This causes puberty and the secondary sex characteristics to develop normally. For boys, testosterone is administered in gradually increasing doses. The goal is to mimic how the body normally produces testosterone.

Testosterone replacement presents its own set of risks. These risks include blood clots, prostate enlargement and heart attack. The treatment can also worsen a case of prostate cancer. Routine checkups are necessary following the initial treatment to maintain a normal level of testosterone.