Table of Contents
Definition of Hypogonadism
Dysfunction of the gonads resulting in inadequate production of sex hormones. In men the testicles (also called testes) are the gonads that produce androgens and in women the ovaries are the gonads that produce estrogens.
In primary hypogonadism the ovaries or testicles themselves fail. Genetic reasons for such failure are Turner’s syndrome in females and Klinefelter’s syndrome in males. These genetic disorders result from errors in the sex chromosomes.
Hypogonadism may also be central, a result of problems with the endocrine mechanisms that regulate the function of the ovaries or testicles. The most common of such problems are traumatic injury, surgery, radiation therapy, and chemotherapy.
Tumors of the pituitary gland, untreated hypothyroidism, and eating disorders such as anorexia nervosa that result in severe nutritional deficiency, may also cause central hypogonadism. Symptoms of hypogonadism depend on the developmental stage of the individual.
Primary hypogonadism that occurs in childhood, such as resulting from Turner’s syndrome or Klinefelter’s syndrome, causes absence of puberty and failure to develop secondary sexual characteristics. Hypogonadism that develops in adulthood results in menopausal symptoms such as hot flashes in women and diminished libido, erectile dysfunction, and sparsity of facial hair in men.
Diagnosis and Treatment
The diagnostic path includes blood tests to measure blood levels of estrogen, testosterone, follicle-stimulating hormone (fsh), luteinizing hormone (lh), and thyroid hormones.
Treatment for primary hypogonadism in most situations is hormone therapy to restore blood levels of the sex hormones to normal levels for the person’s age. When hypogonadism is central, treatment targets the underlying cause.
Hormone therapy initiates puberty when hypogonadism occurs in childhood. However, fertility issues may remain even with treatment though other symptoms typically improve.
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