Hypogonadism is a condition in which the gonads (which are the sexual organs) don’t function to their full extent.This can happen to both men and women. For example, gonads in men (the testes) are responsible for producing the hormone testosterone and also gametes (sperms). When such gonads start losing their functionality and malfunction, hypogonadism occurs.
Since the gonads are very important body parts, hypogonadism brings along many issues. There are many types of hypogonadism and this problem can be classified into several categories based on the defective part in the entire reproductive system that’s causing the problem.
Classification of Hypogonadism
Based On the Affected System
There are two major types that hypogonadism is divided into – primary hypogonadism and secondary hypogonadism.
- If the problem lies in the gonads, then it is termed as primary hypogonadism. Disorders like mumps can cause the testicles to malfunction, and this falls under primary hypogonadism. Even Turner syndrome and Klinefelter syndrome can be classified under primary hypogonadism.
- Any kind of problem that rises due to defects in the brain can be classified under secondary hypogonadism. This is because the brain plays a key role in controlling the gonads, and any problems with the pituitary region or the hypothalamus can result in secondary hypogonadism. Hypopituitarism is a defect of the pituitary section of the brain which can be classified under secondary hypogonadism, along with Kallmann syndrome, which occurs when there’s a defect with the hypothalamus.
Easily put, primary causes of hypogonadism are due to defects that are within the gonads and secondary causes of hypogonadism are due to defects that lie outside in other organs and systems.
In order to determine whether the hypogonadism in a particular patient has a primary or secondary cause, doctors closely note the gonadotrophins in the patient. If the problem lies in the gonads (due to primary hypogonadism), the levels of the gonadotrophins FSH and LH are elevated. If FSH and LH levels are either low or normal, then secondary hypogonadism should be the likely cause.
Congenital and Acquired
Hypogonadism can also be classified into two types – congenital hypogonadism and acquired hypogonadism.
- Congenital hypogonadism is caused by defects that the affected individual carries from birth, due to genital problems. For example, Klinefelter syndrome and Turner syndrome are two types that can be classified under congenital hypogonadism.
- Anabolic Steroids Induced Hypogonadism is one type of acquired hypogonadism. Even childhood mumps can be an example of hypogonadism that is acquired.
Hypogonadism can also be classified on the basis of its effects – this is because some types of hypogonadism affect hormone production while other types affect fertility on the whole.
- The types of hypogonadism that impact fertility more than hormone production are Kartagener syndrome and Klinefelter syndrome.
- The types of hypogonadism that impact hormone production more than fertility are Kallmann syndrome and hypopituitarism. In these conditions, hormone replacement is a must because their levels drop to very low margins.
Diagnosing Hypogonadism
There are different diagnostic procedures used for detecting hypogonadism in men and women.
Diagnosis of Hypogonadism in Men
In men, hypogonadism is detected by running a blood test and checking testosterone levels. Low levels of the sex hormone testosterone in men can cause hypogonadism, and this blood test is carried out during the morning hours because testosterone levels in men are high during this time.
The amount of free testosterone in the body is also tested and verified. Testosterone levels in males should range around 300 to 1000 ng per deciliter, as this is the normal value.
Diagnosis of Hypogonadism in Women
In women, FSH and LH levels will first be noted, to see if the symptoms point towards menopause. This is mainly because the levels of these components change during the menstrual cycle, and once menopause if ruled out, the causes for hypogonadism can then be detected.
Sometimes the cause of hypogonadism can also be psychological, and in such cases, blood tests will be useless. Erectile dysfunction, reduced libido, lethargy, depression, infertility and low self esteem can also cause hypogonadism.
Treatment Measures for Hypogonadism
Since hypogonadism in males is mainly due to low testosterone levels, testosterone replacement therapy, also known as TRT, is a treatment procedure used to cure this condition. Testosterone levels in the body can be increased through the help of gels, skin patches, pellets or injections. Oral supplements were once used, but these aren’t effective anymore, so they’re vastly ignored (as the liver can break down testosterone).
Treatment measures for women include progesterone replacement and estradiol replacement, as these components can help in getting their libido up and running. Sometimes women are given testosterone supplements too, to kick start their libido.
It’s better for you to consult a doctor and verify whether your condition is treatable or not, before you take any further decisions. Some forms of fertility disorders have no treatment, so it’s better to be aware.
