Causes of Hypogonadism

Male hypogonadism means the testicles don’t produce enough of the male sex hormone testosterone. There are two basic types of hypogonadism:

  • Primary. This type of hypogonadism — also known as primary testicular failure — originates from a problem in the testicles.
  • Secondary. This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland — parts of the brain that signal the testicles to produce testosterone.

Either type of hypogonadism can be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. At times, primary and secondary hypogonadism occur together. The possible causes for both primary and secondary hypogonadism are listed below:


The causes of primary hypogonadism (Testicular failure) are:

  • Congenital disorders:

– Androgen receptor/enzyme defects

– Chromosomal defects, for example; Klinefelter’s syndrome


  • Physical damage to the testicles:

– Surgical removal

– Chemotherapy

– Testicular trauma


  • Acquired:

– Testosterone and/or anabolic steroid abuse

– Radiation exposure


Complications of illness:

– E.g. Diabetes, renal failure, alcoholic liver disease

The causes of secondary hypogonadism are:

  • Congenital disorders:

– Idiopathic hypo gonadotrophic hypogonadism (IHH)

– Kallmann’s syndrome


  • Pituitary disorders:

– Hyperprolactinaemia

– Pituitary insufficiency


  • Acquired:

– Steroid abuse

– Chronic Opiate use

– Obesity


  • Complications of Illness:

– Malnutrition

– Diabetes mellitus

– Anorexia Nervosa


Adapted from: