Hypogonadism pictures

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What you need to know about male hypogonadism

Male hypogonadism, also known as testosterone deficiency, is a failure of the testes to produce the male sex hormone testosterone, sperm, or both.

It can be due to a testicular disorder or the result of a disease process involving the hypothalamus and pituitary gland.

Hypogonadism can affect many organ functions and it can have a negative impact on quality of life.

The signs and symptoms depend on when it starts, how severe the deficiency is, and whether or not there is a decrease in the major functions of the testes.


A lack of testosterone can cause a wide range of symptoms.

These depend on:

  • the age of onset
  • the degree of testosterone deficiency
  • how long the loss has been occurring

Adolescents and young adults who have not yet completed puberty appear younger than their chronological age.

They may also have small genitalia, a lack of facial hair, failure of the voice to deepen, and difficulty gaining muscle mass, even with exercise.

Puberty-onset hypogonadism can lead to:

  • impaired sexual development
  • decreased testicular size
  • enlarged breasts

Symptoms of adult-onset hypogonadism include:

  • erectile dysfunction
  • low sperm count
  • depressed mood
  • decreased libido
  • lethargy
  • sleep disturbances
  • decreased muscle mass and strength
  • loss of body hair (pubic, axillary, facial)
  • osteoporosis and decreased bone mineral density
  • increased body fat
  • breast discomfort and enlargement
  • hot flashes
  • sweating
  • poor concentration and decreased energy


Hypogonadism in a male refers to a decrease in either or both of the two major functions of the testes: sperm production and testosterone production.

This can happen for a number of reasons.

In primary hypogonadism, the testicles do not respond to hormone stimulation. This can be due to a congenital disorder such as Klinefelter’s syndrome, or acquired as a result of radiation treatment, chemotherapy, mumps, tumors or trauma to the testes.

In secondary hypogonadism, a disease state interferes with either the hypothalamus or pituitary gland, the main glands that release hormones to stimulate the testes to produce testosterone.

Situations that can cause secondary hypogonadism include:

Andropause is sometimes used to describe decreased testosterone due to the normal aging process. Testosterone levels in males increase until the age of 17 years. Then, starting at approximately 40 years of age, testosterone levels begin to decline at 1.2-2 percent per year.

Risk factors for hypogonadism include type 2 diabetes, obesity, renal failure, HIV, hypertension, chronic obstructive pulmonary disease (COPD) and taking glucocorticoid (steroids), opioid or antipsychotic medication therapy.


Testosterone replacement therapy (TRT) is the recommended treatment for male hypogonadism.

It is normally given as a topical gel, transdermal patch, or by injection. Oral forms of testosterone are not used due to the high risk of side effects, such as upset stomach.

TRT can eliminate many, if not all, of the signs and symptoms of male hypogonadism.

Benefits include:

  • increased libido
  • mood improvement
  • increased bone mineral density
  • overall improved quality of life

However, there are a few risks associated with it.

It may lead to worsening of benign prostatic hyperplasia (BPH), acceleration of pre-existing prostate cancer, and worsening of both sleep apnea and congestive heart failure. TRT should not be started without first attending to these conditions.

All males who are using TRT require ongoing medical evaluation to determine adequate response to treatment. This will include regular blood tests and periodic digital rectal exams.

TRT is contraindicated in men with erythrocytosis, a condition involving a high volume percentage of red blood cells in the blood.

The response to TRT is individualized, and testosterone levels are not an indicator of who will respond to TRT and who will not. It is also worth noting that while it can relieve symptoms of hypogonadism, TRT does not restore fertility.

Female hypogonadism

Hypogonadism can also affect females. In women with hypogonadism, the ovaries produce low levels of female sex hormones. This affects the functioning of the ovaries and the reproductive system.

Symptoms include delayed puberty and a lack of menstruation or irregular menstruation. Breasts may not develop fully and height may be affected. This may be due to a genetic problem, an autoimmune condition, or a range of environmental factors.

After puberty, a wide range of factors can lead to hypogonadism, including tumors, eating disorders, genetic problems, and surgery, such as a hysterectomy.

Symptoms will include hot flashes, mood changes, changes in energy levels, and discontinued menstruation.


Some lifestyle changes can help boost testosterone levels.

These include:

  • losing weight
  • exercising
  • managing stress
  • getting adequate sleep
  • avoiding alcohol
  • giving up smoking.

The measures can help maintain normal testosterone levels.


If an individual is at risk of or may have hypogonadism, a doctor will take a thorough medical history taken and carry out a physical examination, including blood tests.

Two key blood tests must be carried out to confirm the presence of hypogonadism:

  • serum total
  • free testosterone

The normal range of these blood tests has some variability, but a reading of between 300 and 1,000 nanograms per deciliter (ng/dL) is considered normal. Levels will be below the normal range in a person with hypogonadism.

For accuracy, the blood test should be drawn between the hours of 7.00 and 11.00 in the morning on at least two occasions. Additional testing may be necessary to confirm a diagnosis of hypogonadism.


Awareness of male hypogonadism is growing, but many adult men with the condition remain undiagnosed and untreated. This may negatively influence both their quality of life in men and their life span.

Any male who thinks he may have low testosterone levels should seek medical advice, as treatment can reverse most of the symptoms and risks of male hypogonadism.

However, before starting treatment with TRT, all men should discuss the risks and benefits with their health care provider.

Sours: https://www.medicalnewstoday.com/articles/307634

[Therapy of male hypogonadism]

One of the most frequent, but also most undiagnosed, endocrinopathies is male hypogonadism (testosterone deficiency). Understanding the variety of clinical pictures male hypogonadism exhibits is pivotal for diagnosis and putative treatment. There can be disturbances of mood and cognitive abilities as well as sexual functions. Further on, a decrease in muscle mass and strength, an accumulation of body fat and osteopenia/osteoporosis as well as anemia might be observed. There are indications that insulin sensitivity is mitigated in a state of androgen depletion, especially due to an inverse association of testosterone to the metabolic syndrome. In older men, symptoms of androgen deficiency may feature a differential profile due to accompanying co-morbidities. Restoring serum testosterone levels by substitution therapy can markedly attenuate, if not relieve, the clinical picture of hypogonadism. New treatment modalities have been introduced, including short-acting transdermal as well as long-acting depot preparations. Herewith, the diagnostic pathways to describe or exclude male hypogonadism and as well as various options of initiation and surveillance of testosterone substitution therapy are elucidated. Future perspectives of andrology regarding metabolic and pharmacogenetic aspects are discussed.

Sours: https://pubmed.ncbi.nlm.nih.gov/18351310/
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Male hypogonadism: Symptoms and treatment

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Sours: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255409/
Low Testosterone Therapy


What is hypogonadism?

Hypogonadism occurs when your sex glands produce little or no sex hormones. The sex glands, also called gonads, are primarily the testes in men and the ovaries in women. Sex hormones help control secondary sex characteristics, such as breast development in women, testicular development in men, and pubic hair growth. Sex hormones also play a role in the menstrual cycle and sperm production.

Hypogonadism may also be known as gonad deficiency. It may be called low serum testosterone or andropause when it happens in males.

Most cases of this condition respond well to appropriate medical treatment.

What are the types of hypogonadism?

There are two types of hypogonadism: primary and central.

Primary hypogonadism

Primary hypogonadism means that you don’t have enough sex hormones in your body due to a problem in your gonads. Your gonads are still receiving the message to produce hormones from your brain, but they aren’t able to produce them.

Central (secondary) hypogonadism

In central hypogonadism, the problem lies in your brain. Your hypothalamus and pituitary gland, which control your gonads, aren’t working properly.

What are the causes of hypogonadism?

The causes of primary hypogonadism include:

Central hypogonadism may be due to:

  • genetic disorders, such as Kallmann syndrome (abnormal hypothalamic development)
  • infections, including HIV
  • pituitary disorders
  • inflammatory diseases, including sarcoidosis, tuberculosis, and histiocytosis
  • obesity
  • rapid weight loss
  • nutritional deficiencies
  • use of steroids or opioids
  • brain surgery
  • radiation exposure
  • injury to your pituitary gland or hypothalamus
  • a tumor in or near your pituitary gland

How is hypogonadism diagnosed?

Your doctor will conduct a physical exam to confirm that your sexual development is at the proper level for your age. They may examine your muscle mass, body hair, and your sexual organs.

Hormone tests

If your doctor thinks you might have hypogonadism, they’ll first check your sex hormone levels. You’ll need a blood test to check your level of follicle-stimulating hormone (FSH) and luteinizing hormone. Your pituitary gland makes these reproductive hormones.

You’ll have your estrogen level tested if you’re female. If you’re male, you’ll have your testosterone level tested. These tests are usually drawn in the morning when your hormone levels are highest. If you’re male, your doctor may also order a semen analysis to check your sperm count. Hypogonadism can reduce your sperm count.

Your doctor may order more blood tests to help confirm a diagnosis and rule out any underlying causes.

Iron levels can affect your sex hormones. For this reason, your doctor may check for high blood iron levels, typically seen in hemochromatosis.

Your doctor may also wish to measure your prolactin levels. Prolactin is a hormone that promotes breast development and breast milk production in women, but it’s present in both genders.

Your doctor may also check your thyroid hormone levels. Thyroid problems can cause symptoms similar to hypogonadism.

Imaging tests

Imaging tests can also be useful in diagnosis. An ultrasound uses sound waves to create an image of the ovaries and check for any problems, including ovarian cysts and polycystic ovary syndrome.

Your doctor may order MRIs or CT scans to check for tumors in your pituitary gland.

What are the treatments for hypogonadism?

Treatment for female hypogonadism

If you’re female, your treatment will involve increasing your amount of female sex hormones.

Your first line of treatment will probably be estrogen therapy if you’ve had a hysterectomy. Either a patch or pill can administer supplemental estrogen.

Because increased estrogen levels can increase your risk of endometrial cancer, you’ll be given a combination of estrogen and progesterone if you haven’t had a hysterectomy. Progesterone can lower your risk for endometrial cancer if you’re taking estrogen.

Other treatments can target specific symptoms. If you have a decreased sex drive, you may receive low doses of testosterone. If you have menstrual irregularities or trouble conceiving, you may receive injections of the hormone human choriogonadotropin or pills containing FSH to trigger ovulation.

Treatment for male hypogonadism

Testosterone is a male sex hormone. Testosterone replacement therapy is a widely used treatment for hypogonadism in males. You can get testosterone replacement therapy by:

Injections of a gonadotropin-releasing hormone may trigger puberty or increase your sperm production.

Treatment for hypogonadism in men and women

Treatment for males and females is similar if the hypogonadism is due to a tumor on the pituitary gland. Treatment to shrink or remove the tumor may include:

  • radiation
  • medication
  • surgery

What is the long-term outlook?

Unless it’s caused by a treatable condition, hypogonadism is a chronic condition that may require lifelong treatment. Your sex hormone level may decrease if you stop treatment.

Seeking support through therapy or support groups can help you before, during, and after treatment.

Sours: https://www.healthline.com/health/hypogonadism

Pictures hypogonadism


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