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Hypogonadism is an endocrine disorder, characterized by decreased activity of reproductive glands, also called as gonads. This condition disturb biosynthesis of sex steroid hormones in testes and ovaries, respectively in males and females. Those hormones are responsible for maintaining proper sex features, like breast, hair and muscle development. Hypogonadism is frequently triggered by autoimmune disorders, infections or genetic abnormalities. The most common symptoms and signs for both genders include decreased sex drive, loss of body hair, hot flashes and abnormal breast growth. Although this condition may be treatable, most of the incidents require lifelong therapy.
Hypogonadism results in decreased activity, or total failure, of testes in males and ovaries in females. Those reproductive glands, also referred to as gonads, are producing sex hormones, primarily androgens and estrogens. Sex steroid hormones are responsible for shaping sex characteristics, and their insufficiency may further disturb breast development, muscle and bones growth, body hair growth, fat deposits location and size, etc. But what is more important, it can also interrupt spermatogenesis (sperm production) and ovulation (egg production), which eventually leads to infertility.
Two major types of hypogonadism include:
- Primary hypogonadism – decreased activity is caused by malfunction originating within the gonad. Sex glands are stimulated, but are no more able to respond to signals and begin hormone production.
- Secondary (central) hypogonadism – caused by malfunctions originating from the outside of the gonad. Although glands are able to operate, they do not receive proper instructions. It can be caused by, e.g. diabetes mellitus, polycystic ovary syndrome or kallmann syndrome.
There are several possible causes of hypogonadism, and they vary depending on type of the disease. Unfortunately, truly effective prevention is currently unknown, since the disease can be triggered in number of ways. Primary type may be caused, for instance, by certain autoimmune disorders, radiation therapy, severe infections or liver and kidney disease. On the other hand, secondary (central) hypogonadism may be triggered by anorexia nervosa, pituitary disorders, obesity, sudden weight loss or nutritional deficiencies. What is more, genetic disorders and infections can cause both primary and secondary hypogonadism.
Hypogonadism symptoms and signs
Symptoms and signs that are present in males include:
- Breast enlargement
- Reduced height
- Loss of body hair
- Diminished growth of testicles and penis
- Hot flashes
Whereas symptoms in females include:
- Menstruation breaks
- Diminished growth of breast
- Mood changes
- Hot flashes
- Loss of body hair
- Decreased libido (sex drive)
Diagnosis and treatment
Apart from physical examination, which will reveal visible signs, the doctor will usually perform hormone level tests or imaging. Although androgens and estrogens are produced by both sexes, they are measured respectively in males and females. In general, the diagnosis is based on simple blood test. It is done at the morning, since hormone levels can be changed significantly during the day. Magnetic resonance imaging or computed tomography of reproductive or pituitary glands may also be performed, in order to reveal any structure changes or tumors.
Usual treatment for both sexes include hormone replacement therapy. Estrogen and progesterone intake is used for women, while testosterone is used for men. An alternative method include clomifene-based therapy, which may naturally boost hormone levels. Treatment is usually lifelong, with very few exceptions. However, if the tumor is causing the disease, healthcare providers may perform surgery or radiation therapy.