Hypogonadism

Also known as: male hypogonadism, idiopathic hypogonadotropic hypogonadism, testosterone deficiency, primary hypogonadism, secondary hypogonadism

What is hypogonadism?

The testicles function as part of a brain/gonad (testis in boys) system that stimulates the testes to secrete the male sex hormone called testosterone. Hypogonadism occurs when any part of this system doesn't function appropriately.

  • Primary hypogonadism is where the testes don't work properly.
  • Secondary hypogonadism is where the problem originates in the brain (pituitary/ hypothalamus).

Hypogonadism may occur during intrauterine fetal life, in prepubertal boys, and after puberty.

What causes hypogonadism?

Primary hypogonadism may be caused by many conditions including:

  • Genetic abnormalities
  • Abnormal development of the testes
  • Damage to the testes by infection
  • Injury or other diseases
  • Radiation or chemotherapy

Secondary hypogonadism may be caused by a number of genetic mutations in genes that cause the pituitary/hypothalamus not to produce the hormones that stimulate the testes, as well as damage to the the pituitary or hypothalamus (by infection, disease or injury), surgery/radiation to that area of the brain, medications and other causes.

What are the signs/symptoms of hypogonadism?

Signs and symptoms depend on when the lack of testosterone begins. During fetal development less testosterone can result in a boy with female genitalia/ambiguous genitalia or underdeveloped male characteristics.

In prepubertal boys hypogonadism may result in:

  • delayed puberty
  • lack of muscle development
  • no change in voice depth
  • lack of hair growth
  • small penis and testicles
  • and perhaps some increase in breast size.

In adult men hypogonadism can lead to infertility, erectile dysfunction and loss of body hair, bone or muscle mass, fatigue and decreased sex drive.

What are hypogonadism care options?

Treatment depends on the cause. Replacement of testosterone is the primary treatment for hypogonadism which is available in a number of different forms, from patches to gels to injections and several other forms.


Reviewed by: Jack Wolfsdorf, MD, FAAP

This page was last updated on: July 25, 2022 02:59 PM

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