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Hypogonadism - Symptom, Treatment And Causes

Last Updated: Jun 09, 2022

What exactly is Hypogonadism?

Hypogonadism is a type of sexual condition that takes place when the sex glands of a person do not function properly resulting in either complete lack of production of sex hormones or in minute amounts. The sex glands are also referred to as gonads and happen to be chiefly the ovaries in females and testes in men. Secondary sex characteristics such as the development of testes in males and the development of breasts in women in addition to the growth of pubic hair are controlled to a large extent by sex hormones. Hormones also serve to perform a function in the production of sperms and in the menstrual cycle in females.

Hypogonadism is also referred to as gonad deficiency. In males, it is also termed as andropause or a condition of low serum testosterone.

What are the symptoms of Hypogonadism?

Hypogonadism is a health condition characterized by a decreased or no production of sex hormones. It affects both males and females. It disturbs the development of secondary sexual characters. Some of the important hypogonadism symptoms may include:

  • In females:
    • Absence of menstruation
    • Retarded growth of breasts
    • Milk-like discharge from breasts
    • Low sex-drive
    • Hot flashes and loss of body hair
  • In males:
    • Loss of muscles and body hair
    • Abnormal growth of breasts
    • Abnormally low growth of penis and testes
    • Erectile dysfunction and fertility
Summary: Hypogonadism signs and symptoms are associated with abnormal development of secondary sexual characteristics in males as well as females. Loss of body hair, disturbed menstruation in females, infertility and erectile dysfunction in males, etc. are some important symptoms experienced.

Variants of Hypogonadism

Hypogonadism has been found to occur in two different variants viz. central and primary hypogonadism.

Primary Hypogonadism - A person suffering from primary hypogonadism basically suffers from a deficiency of sex hormones which occurs due to problematic gonads. They continue to receive instructions from the brain to produce sex hormones but simply cannot produce them.

Central Hypogonadism – Central Hypogonadism is also sometimes referred to as secondary hypogonadism. The culprit in this variant of the disease is the brain. This condition results from the dysfunction of the pituitary gland and the hypothalamus which is responsible for controlling the gonads.

How is Hypogonadism diagnosed?

Effects of hypogonadism involve decreased production of sex hormones in males as well as females, causing irregular development of the secondary sex characteristics. A proper diagnosis, followed by appropriate treatment is important to resolve such health issues.

Steps involved in diagnosis include:

  • Physical examination: This involves a detailed examination of muscle mass, body hair, and sex organs to confirm if the sexual growth in the particular individual is proper or not.
  • Hormone tests: Blood tests are done in this step. The main purpose is to check for the levels of sex hormones in males and females.
  • Imaging tests: These include ultrasound to check for any abnormality such as ovarian cysts in the ovaries of females.
Summary: A proper diagnosis of conditions like Hypogonadism is important as based upon this, the right treatment strategy is decided.
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How to prevent Hypogonadism?

Prevention of hypogonadism can be done. If the condition is caused due to genetic factors or any damage to the pituitary gland or sex organs, prevention is not possible. However, in other cases, the following are some of the ways to prevent the disease:

  • A healthy lifestyle
  • Weight management
  • Maintaining a good nutrition
  • Physical activities and exercises
  • Avoiding excessive consumption of alcohol
Summary: Hypogonadism prevention is possible through some lifestyle changes including healthy weight management, good nutrition, physical exercise, avoiding excessive alcohol consumption, etc.

Can Hypogonadism go away on its own?

Hypogonadism cannot be resolved spontaneously. It requires treatment based on the cause of the condition. If hypogonadism causes involve any genetic factor or damage to the pituitary gland or primary sex organs, it becomes a chronic condition.

It cannot be treated permanently in such cases and requires lifelong treatment. However, in cases involving other causes, it can be resolved completely with appropriate treatment.

Summary: Hypogonadism does not resolve itself and always requires treatment depending upon the cause. It may be chronic or lifelong when genetic factors are involved.

Why do they take place?

  • The causes which instigate primary hypogonadism are:
  • The primary issue may lie with the genes. Genetic disorders like Klinefelter syndrome and Turner syndrome often result in primary hypogonadism.
  • Some autoimmune disorders also may result in the condition. Such disorders include hypoparathyroidism and Addison’s disease.
  • Infections that are of a severe nature may also result in primary hypogonadism.
  • Diseases of the liver are another cause of this variant of hypogonadism.
  • Kidney diseases may also eventually lead to primary hypogonadism.
  • Another cause may be undescended testes.
  • If your body happens to absorb too much of iron, it leads to hemochromatosis which too may serve to lead to the disease.
  • Exposure to radiation is another common cause.
  • Surgery performed on the sex organs may result in the disease.

Causes of Central Hypogonadism

Secondary or Central Hypogonadism may result from:

  • Disorders of the genes like Kallmann syndrome.
  • Infections like AIDS and HIV.
  • Pituitary gland disorders.
  • Inflammatory diseases.
  • Rapid loss of weight.
  • Obesity
  • Use of opiates or steroids typically when used for a long time.
  • Deficiency in nutrition.
  • Exposure to radiation.
  • Surgery performed on the brain.
  • If the hypothalamus or the pituitary is injured for any reason.
  • Tumors around or in the pituitary.

How is Hypogonadism treated?

Hypogonadism treatment mainly depends upon the cause and severity of the symptoms. The treatment methods are different in males and females and involve increasing the number of sex hormones. Important treatment ways may include:

  • In females:
    • Estrogen therapy: This is the first line of treatment in women with hysterectomy. Supplemental estrogen is administered with the use of pills or a patch.
    • Estrogen and progesterone combination: Estrogen can increase the risks of endometrial cancer, hence a combination is preferred.
  • In males:
    • Testosterone replacement therapy: It involves the administration of testosterone in men through injection, patch, gel, and lozenge. This is the most common method to treat hypogonadism in males.
Summary: Hypogonadism treatment in males and females mainly depends on the cause of the condition. It usually involves the administration of sex hormones in the body through injections, patches, pills, lozenges, etc.

Who is eligible for the Hypogonadism treatment?

Any individual suffering from hypogonadism should undergo diagnosis and treatment as such conditions do not resolve spontaneously. The treatment may be continuous and lifelong when the cause is genetic.

Permanent recovery is not possible in such cases. Hence, the affected individual is eligible for treatment in each and every case of hypogonadism.

Summary: Every individual suffering from hypogonadism is eligible for treatment as spontaneous recovery is not possible in such conditions.

Who is not eligible for the Hypogonadism treatment?

Each and every individual suffering from hypogonadism is eligible for the treatment. The symptoms associated with stopped or decreased secretion of sex hormones cannot resolve spontaneously.

Treatment is necessary depending upon the cause of the disease. It may be continuous or lifelong while in some cases, it may be completed in an estimated time interval.

Summary: Any male or female suffering from hypogonadism should undergo treatment as there are no other alternatives. Any delay or ignorance of the condition may lead to certain complications.

What are the Hypogonadism post-treatment guidelines?

The post-treatment guidelines of hypogonadism include preventive measures that one should strictly follow in order to prevent any recurrence or complications. Some of the important post-treatment guidelines may include:

  • Regular medical check and follow-ups under medical supervision.
  • Maintaining a healthy and nutritious diet always
  • Maintaining a healthy body weight
  • Doing physical activities or exercises on a regular basis
  • Having a sufficient amount of sleep
  • Avoid unhealthy foods such as packaged and processed food items, high sugar and calorie-rich foods, etc.
Summary: Post-treatment guidelines should be strictly followed in case of hypogonadism so as to prevent risks of recurrence or complications. These are also important to ensure the longevity of the outcome of the treatment.

What are the side-effects of Hypogonadism treatments?

Hypogonadism treatment mainly involves specific therapies such as estrogen therapy, testosterone replacement therapy, a combination of estrogen and progesterone, etc. Though these serve as the best treatment for hypogonadism, they are associated with certain side effects too. Some of the side effects may include:

  • Acne or pimples on the skin
  • Irregularity in sleep cycles
  • Abnormal physical development such as over-or under-development of the breasts
  • Enlargement of prostate glands in males
  • Decreased sperm production in males
  • Abnormally increased production of red blood cells
Summary: Effects of hypogonadism treatment may be harmful in some cases too. It can affect the sexual health of both males and females by decreasing hormone production. It may also cause abnormal physical changes.

Should I go to urgent care for Hypogonadism?

Hypogonadism may be caused due to the development of a tumor in the pituitary gland or any damage to the sex organs. Such conditions are severe and urgent medical care and treatment are needed for their management. When hypogonadism is related to a genetic cause, it becomes chronic and requires lifelong treatment under medical supervision.

Such cases do not require treatment on an urgent basis as the symptoms need to be controlled and managed through specific therapies and medications.

Summary: Hypogonadism may or may not require urgent medical care and treatment depending upon the cause and severity of the disease. In genetic cases, treatment is lifelong and continuous while other cases need treatment on an urgent basis.

What happens if hypogonadism is left untreated?

Hypogonadism is a serious concern as it adversely affects fertility as well as causes abnormal physical changes in males and females. It should undergo proper diagnosis, followed by an appropriate treatment plan. In case it is left untreated, several complications may occur. Some of them include:

  • Loss of libido
  • Decreased physical strength
  • Osteoporosis
  • Psychological stress due to abnormal physical changes
  • Infertility
  • Rheumatoid arthritis
  • Klinefelter’s syndrome
Summary: Hypogonadism is curable but if it is left untreated, it can lead to various complications. It can cause infertility or may trigger rheumatic autoimmune diseases.

How long does it take to treat hypogonadism?

In case hypogonadism is caused due to genetic factors, complete recovery is not possible. Lifelong and continuous treatment is needed in such cases. However, if the reason involves the development of a tumor in the pituitary gland, the treatment is done by surgery, radiation, or chemotherapy. Several weeks or months are required for recovery in such conditions.

Summary: Recovery from hypogonadism may take weeks, months, or years depending upon the cause and severity of the symptoms. If genetic factors are involved, complete recovery is not possible.

What to eat in Hypogonadism

The release of sex hormones in Hypogonadism may be increased by having some specific diet changes. Certain food items work to enhance the production of testosterone as well as estrogen. They also help to maintain fertility. Some of those may include:

  • Herbs like Ginger: This is known to have medicinal properties helpful in enhancing fertility in men, by increasing testosterone production.
  • Foods like oysters, red meat, beans, nuts, poultry, and shellfish: Being rich in zinc, these food items enhance sex hormone production and improve sperm production in males.
  • Pomegranate: The fruit is rich in potent antioxidants which boost the production of sex hormones.
  • Fortified plant milk: It is a rich source of vitamin D, which has a known role in increasing testosterone production in males.
  • Fish oil and fatty fishes: Being rich in strong antioxidants like omega-3 fatty acids, fish oil, and fatty fishes boost the production of sex hormones.
Summary: Although hypogonadism is treated with specific hormonal therapies and with the use of pills, lozenges, patches, etc., the condition may be controlled by some dietary changes. Such food items increase the production of sex hormones naturally.

What not to eat in Hypogonadism?

Although hypogonadism cannot be cured by diet, certain food items play a role in managing the condition. However, there are some foods that may worsen the condition by suppressing the release of sex hormones. Some of those may include:

  • Foods rich in high calories, salt and sugar content: These foods negatively affect sexual health by reducing the number of sex hormones produced. They also cause impaired activity of primary sex organs.
  • Processed foods: These are rich in unhealthy fats such as trans-fat which adversely affect the production of male and female sex hormones.
  • Canned food items: These foods can have a negative impact on the male and female sex hormone levels. They contain compounds like bisphenol A, bisphenol S, etc. which are quite harmful to sexual health.
Summary: It is important for us to know about the impact of food items on sexual health as certain foods suppresses the production and release of male as well as female sex hormones. Those need to be avoided.

What is the price of Hypogonadism treatments in India?

The cost of treatment of hypogonadism mainly involves the expenses related to the treatment methods such as testosterone replacement therapy, estrogen therapy, and a combination of estrogen and progesterone. These methods are quite expensive and may cost around 2 to 3 lakhs on average.

Summary: The cost of treatment of hypogonadism includes the expenses for specific therapies such as testosterone therapy, estrogen therapy, etc. It is quite expensive and unaffordable in countries like India.

Does exercise help hypogonadism?

Exercises do not have any direct effect on conditions like hypogonadism. However, it may indirectly benefit the individual suffering from such hormonal disorders.

Based on research, it has been proved that exercises on a regular basis enhance the effectiveness of specific treatment therapies including testosterone-replacement therapy as well as estrogen-progesterone therapy.

Summary: Physical activities and exercises are beneficial in the case of hypogonadism as they enhance the effectiveness of various treatment therapies such as estrogen therapy or testosterone-replacement therapy.

Which medicine is best for hypogonadism?

The medicines for the treatment of hypogonadism mainly include testosterone-replacement preparations. These preparations are available in various forms and need to be administered accordingly. Important forms of testosterone preparations are:

  • Gel
  • Injection
  • Patch
  • Implantable pellets
  • Nasal
  • Gum and cheeks
Summary:Testosterone-replacement preparations are available in the form of gel, patch, injections, pellets, etc. These contain testosterone which is administered in different ways.

Are the results of the Hypogonadism treatment permanent?

The results of the treatment of hypogonadism may or may not be permanent. In case, hypogonadism is congenital or caused due to genetic reasons, it cannot be cured completely. The symptoms can be managed with a lifelong treatment in such cases.

However, when the condition is acquired later in life due to any injury or infection, it can be treated with specific therapies. The results are usually permanent in such cases.

Summary: The results of the treatment of hypogonadism mainly depend upon the cause of the condition. When the cause is genetic, the results are not permanent while in other cases, permanent recovery is possible.

How do you treat hypogonadism naturally?

Hypogonadism is treated with specific therapies including estrogen-progesterone therapy, testosterone therapy, etc. However, there are certain ways to cure hypogonadism naturally.

These remedies do not have a direct effect on the level of the sex hormones but indirectly they may help to manage such conditions. Some of those natural remedies include:

  • A sufficient amount of sleep daily.
  • Maintaining a healthy weight.
  • Intake of food sources providing the required amount of zinc.
  • Avoiding excessive consumption of sugar.
  • Physical activities and exercises.
Summary: Hypogonadism cure is possible through specific treatment therapies but in certain cases, some natural remedies may help to boost the levels of sex hormones. These remedies indirectly help to control and manage such conditions.

References

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Written ByDr. Vikram Gidwani MBBSSexology
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