Hypogonadism: Meaning, Symptoms, Causes, and Diagnosis

Among Indian men above 40 years of age, the prevalence of male hypogonadism is estimated at 20%-29% as per the National Institute of Health. Despite its prevalence, the condition remains heavily underdiagnosed, largely because patients are often hesitant to discuss symptoms related to sexual health.

This article explains hypogonadism meaning, its causes, hypogonadism symptoms, and how it is diagnosed.

What is Hypogonadism?

The meaning of hypogonadism can be understood by looking at its root. “Hypo” means under or below normal, and “gonadism” refers to the function of the gonads. Together, the term describes a state of reduced or absent hormone production by the sex glands.

There are two main types of hypogonadism:

• Primary hypogonadism: This occurs when the gonads themselves are damaged or unable to produce sufficient hormones, even when the brain sends the correct signals. It is also called hypergonadotropic hypogonadism. Klinefelter syndrome (in males) and Turner syndrome (in females) are common genetic causes.
• Secondary hypogonadism: This occurs when the pituitary gland or hypothalamus in the brain fails to send the right signals to the gonads. It is also called hypogonadotropic hypogonadism. Causes include pituitary tumours, head injuries, or certain chronic illnesses.

What are the Major Hypogonadism Symptoms?

Hypogonadism symptoms vary depending on the age at onset, the sex of the individual, and the severity of hormone deficiency. When the condition develops before puberty, it interferes with normal sexual development. When it develops in adulthood, it causes a different set of changes.

Low testosterone symptoms in males include:

• Reduced sex drive and erectile dysfunction
• Lower muscle mass and increased body fat
• Fatigue and low energy levels
• Reduced facial and body hair growth
• Gynaecomastia or the development of breast tissue in males
• Infertility due to low sperm count
• Mood changes, difficulty concentrating, and depressive symptoms

Low estrogen symptoms and other signs of female hypogonadism include:

• Irregular or absent menstrual periods
• Hot flashes and night sweats
• Reduced libido and vaginal dryness
• Delayed or absent puberty in adolescent girls
• Infertility and reduced bone density over time

What are the Causes of Hypogonadism?

The causes of hypogonadism differ based on its type. Some of the most common causes of primary hypogonadism include:

• Genetic conditions such as Klinefelter syndrome or Turner syndrome
• Undescended testicles in males (if untreated)
• Autoimmune disorders affecting the gonads
• Radiation therapy or chemotherapy
• Infections such as mumps orchitis in males

Common causes of secondary hypogonadism include:

• Pituitary gland tumours or disorders
• Obesity, type 2 diabetes, or metabolic syndrome
• Prolonged use of certain medications, including opioids and steroids
• Severe nutritional deficiencies or eating disorders

How is Hypogonadism Diagnosed?

Diagnosing hypogonadism requires a thorough evaluation of the patient’s symptoms, medical history, and laboratory test results. A doctor, usually an endocrinologist, will assess hypogonadism symptoms alongside blood tests drawn in the morning, when hormone levels are at their highest.

Key diagnostic steps include:

• Blood tests: A low testosterone test measuring serum testosterone levels is the primary investigation for male hypogonadism. For female hypogonadism, oestrogen levels are measured. Diagnosis typically requires at least two low readings on separate mornings.
• LH and FSH testing: Luteinising hormone (LH) and follicle-stimulating hormone (FSH) levels help determine whether the condition is primary or secondary in origin.
• Additional blood tests: Prolactin, thyroid function, iron levels, and a complete blood count may be ordered to identify underlying causes or rule out other conditions.
• Imaging: An ultrasound of the ovaries may be done in females. If a pituitary disorder is suspected, an MRI or CT scan of the brain is performed.
• Genetic testing: If a chromosomal condition such as Klinefelter or Turner syndrome is suspected, genetic testing is conducted.

Individuals experiencing low testosterone symptoms or low estrogen symptoms should seek medical evaluation promptly. Book the Testosterone Total test with Dr. Lal PathLabs as a first step in diagnosis and towards hypogonadism treatment. Download the Dr. Lal PathLabs app now for easy test bookings.

FAQs

1. What is the meaning of hypogonadism?

Hypogonadism is a condition in which the sex glands, or testes in males and ovaries in females, produce insufficient sex hormones. This leads to hypogonadism symptoms such as reduced libido, fatigue, and reproductive difficulties.

2. What are the most common low testosterone symptoms in males?

Low testosterone symptoms in males commonly include reduced sex drive, erectile dysfunction, fatigue, loss of muscle mass, mood changes, and infertility. These symptoms develop gradually and are often mistaken for normal signs of ageing.

3. How is hypogonadism different in males and females?

Male hypogonadism primarily involves low testosterone, leading to reduced libido, muscle loss, and infertility. Female hypogonadism involves low oestrogen and progesterone, causing irregular periods, hot flashes, and infertility. Both forms can be primary or secondary in nature.