Hypogonadism - Symptom, Treatment And Causes

Testosterone is often the subject of jokes but an insufficiency of this hormone is no laughing matter. Along with affecting your sex drive, low levels of testosterone can also affect your ability to concentrate on tasks, lead to high blood pressure and cholesterol. Additionally, it can increase your risk of obesity and type 2 diabetes. Here are a few signs that could indicate low levels of testosterone-

1. Decreased Libido: With age, you may experience a lowered libido but a sudden decline in your sex drive could be caused by a lack of testosterone.

2. Erectile Dysfunction: Lowered levels of testosterone in the body can affect the release of nitric oxide necessary for an erection. Men suffering from lowered testosterone levels often find themselves either not able to have an erection or have erections that are not firm enough for intercourse.

3. Fatigue: Feeling tired at the end of a day is normal but men who have lowered testosterone levels may find themselves feeling extremely tired by lunchtime. You may also notice a loss of drive and enthusiasm.

4. Moodiness: Men with low levels of testosterone often become depressed and dejected. They feel less optimistic than normal and become more irritable.

5. Reduced Muscles: Testosterone is linked to muscle building and hence a lowered level of testosterone can be indicated by a reduction in the arm, chest or leg muscles. Men with low testosterone also find it difficult to build muscle mass.

6. Lowered Attention Span: Testosterone is responsible for focus and attention. Hence, trouble concentrating on work and memory problems can be seen as signs of lowered testosterone levels.

7. Development of Breasts: The lack of testosterone can cause an imbalance of oestrogen to testosterone ratio in the body. As the oestrogen levels get higher, men may find themselves growing breast tissue. This condition is also known as gynecomastia.

8. Bone Problems: A lack of testosterone can affect bone density. This may lead to osteoporosis like conditions and joint pains. Men with low testosterone levels are also more prone to injuries.

9. Lowered Semen Production: Testosterone is directly linked to semen production. The lower a man’s testosterone levels, the lesser the amount of semen produced.

10. Hair Loss: Many men experiencing lowered testosterone levels suffer from hair loss on their head and other parts of the body as well.

The good news is that this disorder can be treated. Hence, if you find yourself experiencing any of these symptoms, consult a doctor at the earliest.

When the reproductive glands produce scant to no hormones like oestrogen or testosterone, then it is known as hypogonadism. These hormones are important for controlling secondary sex characteristics like development of breasts in women and testes in men and growth in pubic hair. Sex hormones are also required for the roles they play in menstrual cycle in women and sperm production in men.

Hypogonadism is curable with the right medicines.

Types of Hypogonadism

1. Primary hypogonadism: In this type, there are not enough sex hormones in your body because of a problem in your gonads (testis or ovary). In primary hypogonadism, the gonads do receive the message from the brain to produce sex hormones but cannot produce them.

2. Central/Secondary hypogonadism: In this type, the brain is wherein the problem lies. The pituitary gland and hypothalamus located in the brain do not work properly.

What causes Hypogonadism

The causes of hypogonadism can be classified according to their types.

In primary hypogonadism, the causes are:

1. Genetic disorders (for example, Turner syndrome in women and Klinefelter syndrome in men)

2. Autoimmune disorders

3. Infection

4. Kidney and Liver disease

5. Radiation

6. Surgery

In central hypogonadism, the causes are:

1. Anorexia nervosa

2. Tumours

3. Bleeding in the pituitary area

4. Trauma

5. Taking certain medicines (for example, glucocorticoids and opiates)

6. Anabolic steroids (alternatives to human testosterone)

7. Surgery

8. Genetic problems (example: Kallmann syndrome- unable to start or complete puberty)

9. Radiation

10. Infections

11. Hemochromatosis (excessive iron)

12. Nutritional deficiencies

Symptoms associated with Hypogonadism

Symptoms of hypogonadism in females include

1. Lack of menstruation

2. Changes in mood and energy

3. Body hair loss

4. Lack of sex drive

5. Milky discharge from breasts

Symptoms of male hypogonadism include

1. Body hair loss

2. Loss in muscles

3. Abnormal growth in breasts

4. Low libido

5. Erectile dysfunction

6. Fatigue

If you wish to discuss about any specific problem, you can consult a Gynaecologist.

Hair transplant is a surgical procedure where hair is surgically implanted on the head. You can opt for this procedure, if you suffer from hair loss and bald spots on your head. The surgery comprises of shifting hair follicles from one part of the head to another. Mostly, hair follicles from back of the head are relocated to the balding areas.

The reasons when you can opt for a hair transplant are

1. Involutional alopecia: It is a form of alopecia where the hair growth tends to decrease due to ageing resulting in thinning and shorter hair. The follicles remain in the telogen phase (resting phase) for an extended amount of time. You may opt for a hair transplant surgery to correct this disorder.
2. Male pattern baldness (Androgenic alopecia): Androgenic alopecia is a condition which is characterized by a gradual receding hairline, especially along the temples. This is caused due to the testosterone hormone being converted in to Dihydrotestosterone (DHT) which causes shrinking of the hair follicles. If you are affected by male pattern baldness, then you may opt for a hair transplant surgery.
3. Female pattern baldness: Females may also be affected by baldness which is characterized by loss of hair from the top of the head and gradual thinning of hair. It may lead to self-esteem issues; so opting for a hair transplant surgery is recommended.
4. Traction alopecia: This type of hair loss occurs due to exertion of external pressure on the hair which may cause it to fall. If the hair does not grow back then it would result in a bald patch. Thus you may opt for a hair transplant procedure if you suffer from this disorder and experience loss of hair.
5. Trichotillomania: This is a psychological condition where a person pulls out his/her hair. If excessive hair is lost resulting in bald spots, then you may opt for hair transplant surgery. If you wish to discuss about any specific problem, you can consult a dermatologist.

Testosterone is often the subject of jokes but an insufficiency of this hormone is no laughing matter. Along with affecting your sex drive, low levels of testosterone can also affect your ability to concentrate on tasks, lead to high blood pressure and cholesterol. Additionally, it can increase your risk of obesity and type 2 diabetes.

Here are a few signs that could indicate low levels of testosterone-

1. Decreased Libido: With age, you may experience a lowered libido but a sudden decline in your sex drive could be caused by a lack of testosterone.

2. Erectile Dysfunction: Lowered levels of testosterone in the body can affect the release of nitric oxide necessary for an erection. Men suffering from lowered testosterone levels often find themselves either not able to have an erection or have erections that are not firm enough for intercourse.

3. Fatigue: Feeling tired at the end of a day is normal but men who have lowered testosterone levels may find themselves feeling extremely tired by lunchtime. You may also notice a loss of drive and enthusiasm.

4. Moodiness: Men with low levels of testosterone often become depressed and dejected. They feel less optimistic than normal and become more irritable.

5. Reduced Muscles: Testosterone is linked to muscle building and hence a lowered level of testosterone can be indicated by a reduction in the arm, chest or leg muscles. Men with low testosterone also find it difficult to build muscle mass.

6. Lowered Attention Span: Testosterone is responsible for focus and attention. Hence, trouble concentrating on work and memory problems can be seen as signs of lowered testosterone levels.

7. Development of Breasts: The lack of testosterone can cause an imbalance of oestrogen to testosterone ratio in the body. As the oestrogen levels get higher, men may find themselves growing breast tissue. This condition is also known as gynecomastia.

8. Bone Problems: A lack of testosterone can affect bone density. This may lead to osteoporosis like conditions and joint pains. Men with low testosterone levels are also more prone to injuries.

9. Lowered Semen Production: Testosterone is directly linked to semen production. The lower a man’s testosterone levels, the lesser the amount of semen produced.

10. Hair Loss: Many men experiencing lowered testosterone levels suffer from hair loss on their head and other parts of the body as well.

The good news is that this disorder can be treated. Hence, if you find yourself experiencing any of these symptoms, consult a doctor at the earliest.  

Low testosterone in men is sometimes treated medically, with testosterone supplementation. In other cases, it can be treated with lifestyle changes such as efforts to lose excess weight and exercise more.

While testosterone therapy has yet to be approved for women in the United States, some doctors do prescribe it off-label to treat sexual problems and other symptoms associated with low testosterone in women.

When an underlying medical condition is causing or contributing to "low T," treating that condition can return the testosterone level to normal.

Treatment Options-

Testosterone can be delivered to the body in a variety of ways:

•     Injections into a muscle can be given every few weeks, either by a medical professional or by self-injection.
•     Patches or gels containing testosterone can be applied to the skin daily.
•     A tablet-shaped patch known as a buccal system can be applied in the mouth where the upper gum meets the inside of the lip. The patch is changed every 12 hours.
•     Testosterone pellets are a newer form of treatment. The pellets are inserted under the skin of the buttocks, where they release testosterone for three to four months.

Men and women who are being treated with testosterone need to have follow-up blood tests to assess how they're responding to treatment.