Both men and women can be affected by hypogonadism. In most cases, the disease can be successfully treated with hormone replacement therapy.
What is hypogonadism?
Diagnostic procedures that are used when hypogonadism is suspected differ, among other things, depending on the respective form of the disease and the individual symptoms. Changed hormone levels can be detected, for example, with the help of blood tests. See AbbreviationFinder for abbreviations related to Hypogonadism.
In general, the term hypogonadism describes an underfunction of the gonads (gonads). In the human body, the gonads are responsible for the production of germ cells (egg cells or sperm) and sex hormones.
However, the term hypogonadism in medical parlance often only refers to an underfunction of the male gonads (the testicles). Hypogonadism is an endocrine (hormonal system) disorder.
A so-called primary hypogonadism is present when the gonads themselves are impaired in their function. Secondary hypogonadism is when the pituitary gland (a hormonal gland in the brain, also known as the pituitary gland) becomes dysfunctional.
Finally, if there is tertiary hypogonadism (which occurs very rarely), the hypothalamus (a regulatory center for endocrine processes located in the brain) is affected by a functional disorder.
Primary hypogonadism in men is usually due to missing or impaired Leydig cells, which are among the most important cells in the testicle. As a result, testosterone production in the affected man is impaired.
In various sub-forms of primary hypogonadism, low testosterone concentration can also be due to factors such as trauma, castration or testicular inflammation. Primary hypogonadism in women can be promoted, among other things, by inflammatory processes or tumors in the gonads. Congenital underdevelopment of the sex organs can also lead to primary hypogonadism in women.
Damage to the pituitary gland as the cause of secondary hypogonadism can be caused, for example, by new tissue formation (tumors) or inflammation. Finally, impairments of the hypothalamus that lie behind tertiary hypogonadism can be congenital or caused by factors such as trauma or various diseases.
Symptoms, Ailments & Signs
Hypogonadism can affect both men and women. Depending on gender and age, the disease manifests itself in different ways. If hypogonadism occurs in children, this is particularly noticeable through the complete absence of puberty. Affected adolescents come to a standstill in puberty development.
In girls, menstruation stops (primary amenorrhea). In boys, enlargement of the male mammary gland (gynecomastia) and undescended testicles (cryptorchidism) are common symptoms. Adolescents of both genders usually have little interest in sex and underdeveloped primary and secondary sex characteristics.
If hypogonadism does not develop until adulthood, the clinical signs of the disease may be less pronounced. Affected people of both sexes usually experience a loss of libido. Other symptoms are the loss of secondary hair and osteoporosis.
In women, depending on the severity, there is a significant drop in estrogen levels and this is accompanied by a pathological involution of the genital organs (genital atrophy) and the absence of menstrual bleeding (secondary amenorrhea). In affected men, the testicles shrink. Another symptom is the absence of mature male sperm cells (azoospermia). In most cases, those affected also have erectile dysfunction up to and including impotence.
Diagnosis & History
Diagnostic procedures that are used when hypogonadism is suspected differ, among other things, depending on the respective form of the disease and the individual symptoms. Changed hormone levels can be detected, for example, with the help of blood tests.
For example, the levels of prolactin (a hormone of the pituitary gland), testosterone and/or estradiol (a sex hormone) are determined on a sex-specific basis. As a rule, most forms of hypogonadism are easily treatable. Possible complications in the course of hypogonadism include, for example, impotence, infertility or cardiovascular diseases.
Both male and female patients are affected by hypogonadism. In most cases, hypogonadism leads to a so-called androgen deficiency. The man can become infertile due to this deficiency and thus also incapable of procreation. In most cases, these restrictions lead to extreme mental stress and the development of depression.
Not infrequently, patients also suffer from inferiority complexes and reduced self-esteem. In the worst case, it can even lead to suicidal thoughts. The partner is also affected by the hypogonadism from psychological complaints and suffers from a reduced quality of life. The sexual organs often regress and can lead to bullying and teasing, especially in children.
Furthermore, children may not go through puberty at all, which leads to serious disruptions in physical and psychological development. It can also cause heart problems, which can lead to death. Hypogonadism is usually treated with hormones and is successful in most cases. There are no particular complications. If depressive moods have developed, these will also be examined by a psychologist. Life expectancy is usually not reduced by hypogonadism.
When should you go to the doctor?
When signs of infertility appear for the first time, a doctor should be consulted. Hypogonadism rarely presents with clear symptoms. Therefore, the first signs of an illness or disorder should be clarified, because this is the only way to avoid subsequent physical and mental problems. Men and women who feel less sexually active or who have had an unfulfilled desire to have children for a long time should consult their family doctor or a gynecologist or urologist.
The doctor can clearly diagnose hypogonadism and suggest appropriate countermeasures. If this happens early, permanent damage can be avoided. In principle, hypogonadism must be clarified if it has a negative effect on the physical and psychological condition. If home remedies and self-measures do not help either, you must go to the doctor with the disorder. The patient must then undergo regular check-ups, as this is the only way to ensure that a lack of androgens, which are responsible for sexual health, does not occur again.
Treatment & Therapy
The treatment of hypogonadism is initially based on the form of the disease: primary hypogonadism is usually treated by administering medication to reduce the presence or absence of sex hormones (in men these are usually androgens such as testosterone, in women estrogens or progestins).
This form of treatment is also referred to in medicine as substitution therapy. In many cases of hypogonadism, lifelong hormone administration is necessary. A substitution therapy can take place in different ways; for example with the help of tablets or injections, but also specific patches. The individually administered amount of hormone depends, among other things, on the age and body weight of the patient.
Secondary hypogonadism is often treated with drugs called gonadotropins. Gonadotropins are sex hormones that help stimulate the gonads. Appropriate preparations can supplement the various pituitary hormones. In the case of secondary hypogonadism, gonadotropin preparations are given above all if there is a desire to have children, because the sex hormone stimulates the formation of sperm or egg cells.
Especially in older men, hypogonadism can be accompanied by symptoms such as depressive mood and/or anemia (low blood count). As a rule, therapeutic steps for the treatment of hypogonadism are supplemented by therapeutic measures that are aimed at the individually accompanying symptoms.
The extent to which hypogonadism can be prevented depends primarily on the individual causes of the disease; secondary hypogonadism can be counteracted, for example, by a balanced diet that prevents the occurrence of deficiency symptoms. Forms of hypogonadism, which can develop as a result of testicular inflammation, can be prevented primarily by treating the inflammatory disease at an early stage.
Targeted follow-up care is part of the treatment of hypogonadism. This is intended to ensure that patients do not tend to depression or other secondary diseases such as anemia. Depending on the individual course of the disease and the symptoms, it may be advisable to change your diet.
A balanced diet rich in vitamins counteracts the typical deficiency symptoms associated with secondary hypogonadism. Iron-rich foods help with anemia. In order for those affected to feel better in the long term and to avoid complications, the hormonal therapy must be consistently observed. Prescribed medication should be taken exactly as planned.
Everyday life after the therapy is relatively normal. The patients are basically hardly restricted, but the sexual disorder can lead to psychological problems. For this reason, the doctor recommends psychotherapeutic care as part of the aftercare. Some people already find it helpful to talk about it with family or friends.
By participating in a self-help course, those affected no longer feel so excluded. The improved self-esteem has a positive effect on mood and the course of the disease. Furthermore, the information helps to assess the situation correctly and to concentrate on the essentials.
You can do that yourself
When hypogonadism occurs, patients are dependent on medical treatment in any case. Hormonal treatment is the only way to permanently alleviate the symptoms and avoid complications. For this reason, patients should take care to take the hormones regularly. In many cases, the therapy can also take place through injections or by sticking on a plaster.
Further treatment measures are therefore not necessary. As a rule, the treatment does not lead to any particular limitations in the patient’s everyday life. In men, hypogonadism can also lead to depression, so that needs to be treated as well. Discussions with close friends, family or your own partner can have a very positive effect on the course of the disease and prevent further complications. Contact with other patients with hypogonadism can also have a positive effect on the course of the disease if there is an exchange of information.
In the case of anemia, a balanced diet can alleviate the symptoms, whereby foods that contain a lot of iron should be consumed in particular. However, anemia can also be controlled with dietary supplements or with the help of transfusions.