Male Hypogonadism – Symptoms and Causes
Overview
Male hypogonadism occurs when the body doesn’t make enough testosterone or sperm. This condition affects masculine growth and development.
The treatment choice depends on the cause of hypogonadism. It also depends on whether it’s present from birth or develops later in life due to injury or infection.
Signs and Symptoms
The male reproductive system has several key parts that work together. The testicles make sperm cells. These cells mix with fluids from the seminal vesicles and prostate gland to create semen.
During sex, the penis releases this semen through ejaculation.
Problems During Early Growth
When the body lacks enough testosterone before birth, a baby’s sex organs may not grow properly. A genetic male baby might be born with:
- Female-looking genitals
- Unclear or mixed genital features
- Underdeveloped male genitals
Changes During Teen Years
Low testosterone during the teenage years can slow or stop normal growth. Boys might experience:
- Less muscle development
- Voice staying high-pitched
- Limited body and facial hair growth
- Smaller penis and testicles
They might also develop:
- Unusually long arms and legs compared to their body
- Breast tissue growth
Problems in Grown Men
Adult men with this condition may notice changes in their body and how they feel. Early warning signs often include:
- Less interest in sex
- Feeling tired more often
- Feeling sad or down
If not treated, men might develop:
- Trouble getting or keeping erections
- Problems having children
- Thinning body and facial hair
- Muscle loss
- Growth of breast tissue
- Weaker bones that break more easily
Some men also experience mental changes similar to what women feel during menopause:
- Trouble focusing on tasks
- Sudden feelings of warmth (hot flashes)
When to Talk to a Doctor
If you notice any of these symptoms, it’s important to see your doctor. Finding out why your body isn’t making enough testosterone is the first step to getting the right treatment. Early care can help prevent or reduce many problems.
What Causes Low Testosterone
The brain plays a key role in testosterone production. Two important parts—the pituitary gland and hypothalamus—work together to tell the testicles to make testosterone.
The hypothalamus makes a hormone that signals the pituitary, which then sends messages to the testicles.
When this system breaks down, testosterone levels can drop. This brain-to-testicle communication is complex but essential for proper hormone balance in men.
Direct Testicular Issues
When the testicles themselves don’t work properly, this causes what doctors call primary testicular failure. Several conditions can lead to this problem:
Chromosome Abnormalities: Men with Klinefelter syndrome have extra X chromosomes that prevent normal testicular development, leading to low testosterone.
Testicles That Don’t Descend: Sometimes testicles don’t move down into the scrotum before birth. If not fixed early in childhood, this can harm testosterone production.
Mumps Infection: Getting mumps that affects the testicles during teen years or adulthood can damage testosterone-producing cells.
Iron Overload: Too much iron in the blood (hemochromatosis) can harm the testicles and reduce hormone production.
Physical Injuries: Because testicles sit outside the body, they can be injured more easily. Damage to both testicles may lower testosterone levels.
Cancer Treatments: Both chemotherapy and radiation can temporarily or permanently affect testosterone production. Men facing these treatments might consider storing sperm beforehand.
Brain Signaling Problems
Sometimes the testicles themselves are healthy, but they don’t receive proper signals from the brain. This secondary problem happens when either the pituitary gland or hypothalamus doesn’t work correctly:
Common causes include:
| Condition | How It Affects Testosterone |
|---|---|
| Kallmann’s Syndrome | Abnormal brain development affects hormone signals and may cause smell problems |
| Pituitary Tumors | Growths near or on the pituitary can block hormone release |
| Brain Treatments | Surgery or radiation for brain conditions may damage the pituitary |
| Inflammatory Diseases | Conditions like sarcoidosis, tuberculosis can affect brain hormone centers |
| HIV/AIDS | Can impact all parts of the hormone pathway from brain to testicles |
| Certain Medications | Opiate pain drugs and some hormones interfere with testosterone production |
| Excess Weight | Being significantly overweight is linked to lower testosterone levels |
| Normal Aging | Testosterone naturally decreases with age, though the rate varies greatly |
Both types of problems—primary and secondary—can sometimes happen together. They might be present from birth or develop later due to illness, injury, or lifestyle factors.
Risk Factors
Several factors can increase your chance of developing hypogonadism:
- HIV/AIDS
- Past cancer treatments (chemotherapy or radiation)
- Getting older
- Excess body weight
- Poor nutrition
This condition can run in families. If relatives have had hypogonadism, tell your doctor about your family history.
Complications
Untreated hypogonadism can lead to several health issues. These problems vary based on when the condition develops.
Common complications include:
- Abnormal genital development
- Gynecomastia (enlarged breast tissue in males)
- Fertility problems
- Difficulty with erections
- Bone density loss (osteoporosis)
- Negative self-perception
The timing of onset affects which complications are most likely to occur.
