Hypogonadism is a condition that causes decreased function of the gonads, which are the testes in males and the ovaries in females, and decreased production of sex hormones. You may be born with the condition or it can develop later in life from injury or infection. Some types of hypogonadism can be treated with hormone replacement therapy.
There are two forms of the condition – primary hypogonadism resulting from problems of the testis or ovary and central hypogonadism caused by problems with the pituitary or hypothalamic glands. Central hypogonadism leads to decreased levels of luteinizing hormone (LH) and follicle stimulating hormones (FSH), released by the pituitary gland.
The condition may have genetic, menopausal, autoimmune and viral causes, or may develop after cancer treatments such as radiation and chemotherapy.
Fasting, weight loss, stress and eating disorders such as anorexia nervosa and bulimia can also cause the condition.
Our approach to hypogonadism
UCSF is an international leader in endocrinology care. Our team provides comprehensive consultations, evaluations and treatments for a wide range of hormone disorders, such as hypogonadism.
In men and premenopausal women, we can usually treat hypogonadism successfully with hormone replacement therapy. We may also use hormonal treatments to restore fertility.
Pituitary tumors cause some cases of hypogonadism, and treatment involves removing the tumor. UCSF surgeons pioneered a minimally invasive procedure to remove pituitary tumors, called the transsphenoidal approach, which is safer than traditional surgery and leaves no scars. UCSF has more experience with this procedure than any other program in the nation and has a record of excellent outcomes.
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Signs & symptoms
In children who have not reached puberty, hypogonadism causes no symptoms. In adolescents, it can delay or prevent sexual development.
Adult women with the condition may stop menstruating or develop infertility, loss of libido, vaginal dryness and hot flashes. Prolonged periods of hypogonadism can cause osteoporosis.
Men with the condition may experience loss of libido, erectile dysfunction, hot flashes, breast growth and infertility.
To diagnose hypogonadism, tests may be performed to check hormone levels – estogren in females and testosterone in males. In addition, levels of luteinizing hormone (LH) and follicle stimulating hormones (FSH) will be tested. LH and FSH are pituitary hormones that are stimulated by the gonads.
Other tests may measure thyroid hormones, sperm count and prolactin, a hormone released by the pituitary gland that stimulates breast development and milk production Tests also may be performed to test for anemia and possible genetic causes of symptoms.
For women, your doctor may request a sonogram of your ovaries.
If pituitary disease is suspected, a magnetic resonance imaging (MRI) scan or computed tomography (CT) scan may be performed to examine the the pituitary gland.
Hormone replacement therapy has proven to be effective treatment for hypogonadism in men and pre-menopausal women.
Estrogen may be administered in the form of a patch or pill. Testosterone can be given by a patch, a product soaked in by the gums, a gel or by injection.
For women who have not had their uterus removed, a combination of estrogen and progesterone is often recommended to decrease the chance of developing endometrial cancer. Low-dose testosterone may be added for women with hypogonadism who have a low sex drive.
Other hormones may be prescribed to restore fertility in men and women.
If the condition is caused by a pituitary tumor, treatment will include surgery to remove the tumor.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.