Hypogonadism is a condition in which the testicles are not working the way they should.

In an adult, the testicles have two main functions: to make testosterone (the male hormone) and sperm. These activities are controlled by a part of the brain called the pituitary. The pituitary sends signals (called gonadotropins) to the testicles that, under normal conditions, cause the testicles to produce sperm and testosterone.

The pituitary signals can change based on the feedback signals that the brain receives from the testicle. Hypogonadism can therefore be divided into two main categories:

  1. A problem with the signals from the brain to the testicles
  2. A problem within the testicle itself

These categories are important because they may influence the way that hypogonadism is treated, and play a role in the results.

What are the types of hypogonadism?

Testicular failure (primary hypogonadism)

Testicular failure occurs when the brain is signaling the testicle to make testosterone and sperm, but the testicles are not responding correctly. As a result, the brain increases the amount of the gonadotropins signals, which causes a higher-than-normal level of these signals in the blood. For this reason, this condition is also referred to as hyper-gonadotropic hypogonadism. This is the most common category of hypogonadism.

Secondary hypogonadism

Secondary hypogonadism (also called hypogonadotropic hypogonadism) occurs when the brain fails to signal the testicles properly. In men who have secondary hypogonadism, the testosterone levels may be very low, and sperm are usually missing from the semen. Some boys are born with this condition. In most cases, it is discovered when a boy fails to go through puberty.

Hypogonadism (primary and secondary) is a clinical condition characterised by low serum testosterone levels occurring in association with any of the signs and symptoms below.\

Adapted from: https://my.clevelandclinic.org

How can low testosterone affect the body?

Low testosterone can be associated with many different complications such as:

  • Poor concentration and a lack of drive
  • Depression
  • Loss of Libido
  • Erectile Dysfunction (ED)
  • Insulin resistance
  • Decreased muscle bulk and power
  • Increased body fat
  • Reduced fertility
  • Decreased genital size
  • Thinning and loss of pubic hair
  • Hot flushes and palpitations
  • Osteoporosis
  • Decreased body hair
  • Disorders of lipid metabolism
  • Anaemia
  • Non-development of secondary sexual characteristics at puberty