Hypogonadism: Causes, Symptoms, Diagnosis, and Treatment


Hypogonadism is a medical condition characterized by reduced or absent production of sex hormones by the gonads (testes in men, ovaries in women). This hormonal imbalance can result in various symptoms and complications, affecting an individual’s overall health and quality of life. This article provides a comprehensive overview of hypogonadism, including its causes, symptoms, diagnosis, and available treatment options.


Hypogonadism can be classified into two main types: primary and secondary.

Primary Hypogonadism: Also known as primary gonadal failure, this type results from a dysfunction in the testes or ovaries themselves. Causes of primary hypogonadism include:
Genetic conditions (e.g., Klinefelter syndrome, Turner syndrome)
Autoimmune disorders
Infections (e.g., mumps)
Radiation or chemotherapy
Testicular or ovarian injury
Secondary Hypogonadism: This type occurs due to a problem in the hypothalamus or pituitary gland, the parts of the brain responsible for regulating hormone production. Causes of secondary hypogonadism include:
Kallmann syndrome (a genetic disorder affecting the hypothalamus)
Pituitary tumors or disorders
Inflammatory diseases (e.g., tuberculosis, sarcoidosis)
Certain medications (e.g., opioids, steroids, hormone therapy)
Obesity, malnutrition, or excessive exercise

The symptoms of hypogonadism can vary depending on the age of onset, the severity of the condition, and the individual’s sex.

In males, symptoms may include:

Delayed puberty
Decreased muscle mass and strength
Reduced facial and body hair
Breast tissue enlargement (gynecomastia)
Low libido and erectile dysfunction
Mood changes and fatigue
In females, symptoms may include:

Delayed puberty
Irregular or absent menstrual periods
Low libido
Vaginal dryness
Mood changes and fatigue

To diagnose hypogonadism, a healthcare provider will typically perform a physical examination, review the patient’s medical history, and order blood tests to measure hormone levels. Additional tests may be required to determine the underlying cause of hypogonadism, such as imaging studies (e.g., MRI) or genetic testing.


Treatment for hypogonadism depends on the underlying cause, the severity of symptoms, and the patient’s individual needs and goals. Common treatment options include:

Hormone replacement therapy (HRT): This is the primary treatment for hypogonadism, involving supplementation with the deficient sex hormone (testosterone for males, estrogen and progesterone for females). HRT can help alleviate many of the symptoms associated with hypogonadism, such as low libido, muscle weakness, and osteoporosis. HRT is available in various forms, including injections, gels, patches, and oral medications.
Fertility treatments: For individuals who wish to conceive, fertility treatments may be recommended. In males, this may involve the use of gonadotropin injections to stimulate sperm production. In females, fertility medications or assisted reproductive techniques, such as in vitro fertilization (IVF), may be employed.
Lifestyle changes: Addressing lifestyle factors that contribute to hypogonadism, such as obesity or excessive exercise, can help improve