Hypogonadism – Definition, Causes and Treatment Options
1. Definition
Hypogonadism in men is a condition where the body doesn’t produce enough testosterone – the hormone responsible for male physical development and reproductive function. It can also mean the testicles don’t produce enough sperm or both sperm and testosterone. This condition can begin during fetal development, puberty or adulthood, and it can affect physical growth, fertility and overall health.
There are two main types of hypogonadism:
- Primary hypogonadism (testicular failure)
- Secondary hypogonadism (problems with the hypothalamus or pituitary gland in the brain)
2. Key Takeaways
- Hypogonadism means low testosterone or poor testicular function in men.
- It can lead to symptoms such as fatigue, low libido, infertility, reduced muscle mass and depression.
- It can be caused by genetic conditions, injury, illness or lifestyle factors.
- Diagnosis is made through blood tests, hormone tests and sometimes imaging.
- Treatment may include testosterone replacement therapy or other fertility treatments.
- Causes of Male Hypogonadism
Several factors can lead to hypogonadism in men. These include:
Primary Causes (testicle-related):
Klinefelter syndrome (a genetic condition)
Undescended testicles
Testicular injury or surgery
Chemotherapy or radiation
Infections like mumps that affect the testicles
Secondary Causes (brain-related):
Pituitary gland disorders
Tumours in the brain
Obesity
Chronic illnesses such as diabetes or liver disease
Use of certain medications (like steroids or opioids).
3. Why Hypogonadism Diagnosis Is Important in Fertility Treatment
When a couple struggles to conceive, male fertility is often part of the investigation. Hypogonadism is a leading cause of male infertility because it directly affects sperm production and testosterone levels – both of which are essential for healthy sperm development and sex drive.
- Impact on Sperm Production
In secondary hypogonadism, the brain fails to signal the testicles to produce sperm, leading to low sperm count or no sperm at all. This is particularly important in fertility treatments like IVF or ICSI, where sperm quality plays a critical role in success.
- Impact on Hormonal Balance
Testosterone levels are closely linked to sexual function, energy levels and mood. Identifying hypogonadism early allows doctors to plan appropriate treatment – either to restore natural sperm production or support fertility through assisted methods.
- Treatment Options for Male Hypogonadism
The choice of treatment varies based on the underlying cause and whether preserving fertility is a goal.
- Testosterone Replacement Therapy (TRT)
TRT helps improve energy, muscle mass, libido and mood but does not restore fertility. It is suitable for men who do not wish to conceive.
Forms of TRT include:
- Gels
- Patches
- Injections
- Pellets under the skin
- Fertility-Focused Treatments
For men who want children, hormone injections (like hCG and FSH) can stimulate the testicles to produce sperm. These treatments may take several months but are often successful.
- Treating Underlying Conditions
If hypogonadism is caused by a tumour, infection or illness, treating the root cause may improve hormone levels and fertility. Weight loss and lifestyle changes can also be helpful in some cases.
- Example/Use Case
A 32-year-old man visits a fertility clinic after a year of trying to conceive with his partner. Tests show he has a low sperm count and low testosterone. Further blood tests confirm secondary hypogonadism. He begins hormone therapy with hCG and FSH injections. After six months, his sperm count improves, and the couple proceeds with IVF treatment.
5. FAQs
Q1: Is hypogonadism the same as low testosterone?
Not exactly. Hypogonadism is the medical term for low testosterone that results from a problem with the testicles or brain.
Q2: Can hypogonadism be cured?
Some causes are treatable or reversible, especially if due to lifestyle or medication. Others may require long-term hormone therapy.
Q3: Will I be able to have children if I have hypogonadism?
Yes, in many cases. If the cause is identified early and the right treatment is given, fertility can be improved or restored.
Q4: What are the symptoms I should watch out for?
Look out for low sex drive, tiredness, loss of body hair, low mood or trouble building muscle. If you’re trying to have a child and are not succeeding, it is worth getting checked.
Q5: How is it diagnosed?
Doctors check testosterone and other hormone levels through blood tests. Additional tests like semen analysis or MRI may be done if needed.
6. Call to Action
If you’re experiencing symptoms like fatigue, low libido or fertility issues, don’t delay — speak to a healthcare professional or fertility specialist. Early diagnosis and personalised treatment for hypogonadism can greatly improve your health, well-being and chances of starting a family.
7. Relevant Terms
Testosterone
Sperm count
Andrology
Pituitary gland
hCG (human chorionic gonadotropin)
FSH (follicle-stimulating hormone)
TRT (Testosterone Replacement Therapy)
Infertility
Semen analysis
Hormone therapy
Klinefelter syndrome
Leydig cells
Gonadotropins
Testicular function
Sperm motility
