Hypogonadism is separated into two types: primary hypogonadism (resulting from dysfunction of the testis or ovary) or central hypogonadism (resulting from pituitary or hypothalamic dysfunction that leads to loss of lutenizing horomne [LH] and follicle-stimulating hormone [FSH]).

Causes of hypogondaism include genetic, menopausual, autoimmune, viral, radiation, and chemotherapeutic agents. Central hypogonadism is often due to pituitary adenomas. Through compression of the gland, these tumors can cause destruction of pituitary tissue or interference with gonadotropin-releasing hormone (GnRH) input from the hypothalamus. Gonadotropin dysfunction is the second most common hormonal disorder from compression of the pituitary gland from a pituitary adenoma after GH suppression. Hypothalamic disorders such as tumors and hypothalamic amenorrhea, as well as exposure to radiation, can lead to hypogonadism. Fasting, weight loss, anorexia nervosa, bulimia, exercise, or stressful conditions result in defects in pulsatile GnRH secretion ("hypothalamic amenorrhea"). Elevated prolactin levels can also suppress GnRH pulses and lead to hypothalamic hypogonadism. Diagonisis requires measurement of LH, FSH, and testosterone or estrogen, with reference to age-adjusted normal values.

Hypogonadism in prepubertal children causes no symptoms, whereas in adolescents, it leads to delayed or absent sexual development.

In adult women, hypogonadism causes:

Prolonged periods of hypogonadism can cause osteoporosis.

In men, hypogonadism leads to:

Most cases of hypogonadism can be successfully treated. Treatment of hypogonadism in men and premenopausal women is effectively accomplished by replacement hormonal therapy. Fertility can be restored by administration of human chorionic gonadotropin, which acts like LH, often in combination with FSH, or by the pulsatile administration of GnRH. Treatment for hypogonadism resulting from a pituitary tumor includes surgery to remove the tumor.

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Hypogonadism | California Center for Pituitary Disorders

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