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Male hypogonadism
Description
Hypogonadism in men is a disease characterized by dysfunction of gonads (testes) resulting in deficiency of sex hormone (testosterone). Sex hormone is important for the development of secondary sexual characteristics like testicular development, pubic and facial hair growth. Testosterone is also important for adequate sperm production. It can be congenital or develops at any age. If, hypogonadism develops before puberty; secondary sexual characteristics don’t develop while hypogonadism after puberty results in lack of sperm production. There are two types of hypogonadism:
- Primary hypogonadism: Inability of testes to produce sex hormone.
- Secondary hypogonadism: Inability of brain to send signals for sex hormone production.
Causes
Hypogonadism causing factors that cannot be changed are:
- Birth defects like undescended testicles (the testis are first formed in the abdomen and afterward, come in the proper position at the time of birth if they fail to come in position, the condition causes defects in the function of testis)
- Genetic defects like Turner syndrome and Klinefelter syndrome.
- Structural defects of sex organs.
- Defects in Hormonal glands.
- Brain defects (tumor, trauma) that affect the brain signaling to gonads (sex glands) for sex hormone production.
- Old age.
Factors that can be changed up to a certain limit:
- A severe form of mumps infection.
- Injury to the testicles (sperm-producing organ).
- Surgery or radiation exposure to the testicles.
- Extension of Liver and kidney disease.
- Long term use of Drug (steroids and opioids)
- HIV and AIDS
- Over-weight and obesity.
- Iron deficiency anemia.
Risk factors
Risk factors of Hypogonadism include:
- Morbid obesity
- Diabetes
- Hypertension
- Renal failure
- HIV/AIDS
- People above 40 years of age
- Malnutrition
- Chemotherapy
Symptoms
Hypogonadism can occur at any age. Symptoms develop according to the age it develops in:
Hypogonadism before puberty:
Before puberty, hypogonadism can negatively affect:
- Growth of penis
- Growth of testicles
- Growth of facial hair
- Growth of body hair
- Deepening of voice
- Growth of Adam’s apple
- Growth of muscle mass
Hypogonadism after puberty:
After puberty, patients with this disease may experience:
- Impotence
- Decreased libido (sexual desire)
- Fatigue
- Sleep disturbances
- Depression
- Anxiety
- Gynecomastia (enlargement of breast in males)
- Decreased bone mass
- Loss of body hair.
Diagnosis
A doctor will examine the age-related growth of sex organs, hair growth, and body mass before performing following confirmatory tests for Hypogonadism.
- Hormone tests for checking the blood levels of testosterone, FSH (follicle stimulating hormone) and LH (luteinizing hormone).
- Semen tests to check the sperm count.
- CBC (complete blood count) for Anemia and iron deficiency because iron affects sex hormones.
- Thyroid tests because sometimes thyroid problems may be confused with signs of hypogonadism.
- Prolactin (milk-producing hormone) levels are measured in males with breast enlargement.
- Ultrasound of the sex organs.
MRI and CT scans are done for the presence of brain tumors or signs of brain defects.
Management
The goal of management is to treat testosterone (male sex hormone) deficiency which results in the symptoms of hypogonadism. The main treatment of hypogonadism is “Testosterone replacement therapy” or androgen replacement therapy. It can be administered in the following way:
- Lozenges
- Intramuscular
- Transdermal patch
- Topical creams.
When to consult a doctor?
The condition is better handled by an Endocrinologist (specialist in hormonal problems) or an Infertility specialist, a doctor trained to give specialized treatment.
Available Medicine for Male hypogonadism
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