CONDITIONS WE TREAT
Hypogonadism
Causes
This condition is caused by the testicles not producing sufficient amounts of testosterone. There is a primary and secondary type. The primary type stems from an issue with the testicles, while the secondary type stems from a problem with the pituitary gland or hypothalamus. Common causes of the primary type include:
Klinefelter syndrome
Mumps orchitis
Testicular injury
Undescended testicles
Cancer treatment
Hemochromatosis
Common causes of the secondary type include:
Kallmann syndrome
Inflammatory disease
Medications
Normal aging
Pituitary disorders
HIV/AIDS
Obesity
Concurrent illness
Symptoms
In adult men, some of the physical characteristics associated with masculinity can become altered and normal reproductive function may be impaired. Symptoms may include:
Infertility
Reduced muscle mass
Bone mass loss
Erectile dysfunction
Body hair and beard growth reduction
Breast tissue development
Reduced sex drive
Hot flashes
Fatigue
Trouble concentrating
Men may also experience emotional and mental changes as their levels of testosterone decline. Symptoms, such as feeling depressed, are possible.
When someone is born with this condition, the level of testosterone deficiency plays a major role in their symptoms.
Diagnosis
A physical examination is usually done first to look at the patient’s characteristics and to determine if the physical signs of hypogonadism is present. In addition, the following tests may be performed:
Hormone testing
Pituitary testing
Testicular biopsy
Semen analysis
Genetic studies
Testing testosterone levels is also common. This testing may continue as the patient undergoes treatment to monitor their progress.
Treatment
Treatments are based on whether the patient is an adult or a child, whether fertility is a concern, and the underlying cause. If a medical condition is causing it, treatment for this may be the first step to see if it helps improve hypogonadism. For adult men, the following may also be considered:
. Assisted reproduction if the patient is trying to achieve conception. When primary hypogonadism is present, no treatment can fully restore fertility, but there are techniques that may help improve the chances of conception.
. Hormone replacement is another option to increase the patient’s testosterone levels.
In children or adolescent boys, testosterone therapy may be considered. There are several methods to administer the testosterone in both adults and boys. Common methods include a patch, injections, topical gel, nasal gel, and implantable pellets. Which option is best depends on several factors and patients will work with their doctors to choose the best one.