Symptoms and causes

Hypogonadism can begin during fetal development, before puberty or during adulthood. Signs and symptoms depend on when the condition develops.

Male hypogonadism means the testicles don't produce enough of the male sex hormone testosterone. There are two basic types of hypogonadism:

  • Primary. This type of hypogonadism — also known as primary testicular failure — originates from a problem in the testicles.
  • Secondary. This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland — parts of the brain that signal the testicles to produce testosterone. The hypothalamus produces gonadotropin-releasing hormone, which signals the pituitary gland to make follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Luteinizing hormone then signals the testes to produce testosterone.

Either type of hypogonadism may be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. At times, primary and secondary hypogonadism can occur together.

Risk factors for hypogonadism include:

  • Kallmann syndrome
  • Undescended testicles as an infant
  • Mumps infection affecting your testicles
  • Injury to your testicles
  • Testicular or pituitary tumors
  • HIV/AIDS
  • Klinefelter syndrome
  • Hemochromatosis
  • Previous chemotherapy or radiation therapy
  • Untreated sleep apnea

Hypogonadism can be inherited. If any of these risk factors are in your family health history, tell your doctor.

The complications of untreated hypogonadism differ depending on what age it first develops — during fetal development, puberty or adulthood.

Sept. 29, 2016
References
  1. Ferri FF. Hypogonadism, male. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 14, 2016.
  2. Snyder PJ. Clinical features and diagnosis of male hypogonadism. http://www.uptodate.com/home. Accessed Aug. 14, 2016.
  3. Khera M, et al. Adult-onset hypogonadism. Mayo Clinic Proceedings. 2016;91:908.
  4. Ask Mayo Expert. Male hypogonadism. Rochester, Minn: Mayo Foundation for Medical Education and Research; 2016.
  5. Snyder PJ. Testosterone treatment of male hypogonadism. http://www.uptodate.com/home. Accessed Aug. 14, 2016.
  6. Snyder PJ. Overview of testosterone deficiency in older men. http://www.uptodate.com/home. Accessed Aug. 14, 2016.
  7. Melmed S, et al. Endocrinology and aging. In: Williams Textbook of Endocrinology. 13th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 14, 2016.
  8. Dietary reference intakes for calcium and vitamin D. Institute of Medicine. http://www.nationalacademies.org/hmd/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D.aspx. Accessed Aug. 14, 2016.
  9. Tournaye H, et al. Concepts in diagnosis and therapy for male reproductive impairment. The Lancet Diabetes & Endocrinology. In press. Accessed Aug. 14, 2016.
  10. Dwyer AA, et al. Transition in endocrinology: Hypogonadism in adolescence. European Journal of Endocrinology. 2015;173:R15.
  11. Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 22, 2016.