Male hypogonadism is defined as inadequate production of testosterone, the male hormone and /or inability to produce enough sperm. Hypogonadism may manifest itself in the form of testosterone deficiency, infertility, or both together. Some males are born with the condition while infection or injury sometime may also lead to hypogonadism.
Symptoms of hypogonadism depend primarily on the age of the male patient at the time of development of the condition. Seldom is the condition apparent before the age of puberty, unless it is associated with retardation of growth or other anatomic abnormalities.
Causes Of Male Hypogonadism
Male hypogonadism is basically related to less production of testosterone hormone from testicles. The condition can be divided into 2 types, namely primary and secondary male hypogonadism.
- Primary: In this type the problem of male sex hormone (testosterone) production originates due to testicular failure. Several medical condition affecting testes can reduce production of testosterone.
- Secondary: In this type, the problem lies in the hypothalamus, a part of brain which signals the testes to produce testosterone hormone.
Both this type can occur either since birth or sometime later in life. Here are some important causes of primary male hypogonadism:
- Undescended testes can lead to decreased or complete absence of sperm production. Normally before birth testes lies in abdomen. But after birth it descends down in scrotum. Sometimes the testes remain in the abdominal cavity even after birth. In this case the testes become dysfunctional.
- Orchitis: Inflammation of testes can decline sperm and testosterone production. Inflammation can occur due to infective medical conditions such as mumps, gonorrhea etc.
- Radiotherapy of testes.
- Absent testes.
- Klinefelter’s syndrome
- Testicular injury can damage the tissue of testicles which may lead to reduced production of testosterone hormone.
Secondary male hpogonadism mainly occurs due to condition in brain.
- Pituitary tumor
- Obesity
- Head injury which damages the hypothalamus.
Signs And Symptoms Of Male Hypogonadism
The symptoms of male hypogonadism depend on the age of a person at which it develops. Usually the symptoms develop after puberty. But sometimes there may be growth retardation observed in child before puberty. Sexual maturity may be delayed. The symptoms may be as follows:
- The penis size is small.
- There is absence of pubic hair.
- Disproportionate long arms and legs.
- Reduced male musculature.
Males who have achieved sexual maturity may manifest following symptoms:
- Loss of sexual desire.
- Loss of penile erection.
- Progressive decrease in muscle mass.
- Infertility.
- Low sperm count or no sperm production.
- Frequent change in mood.
- Small sized testes.
- Hot flushes.
- Decreased body hair.
- Breast enlargement.
Treatment Options For Male Hypogonadism
The goal of treatment is to restore sexual function, libido, fertility, maintain virilization, enhance bone density and prevent osteoporosis. Ideal treatment is testosterone replacement therapy. It can be in variable form such as injections, application of testosterone gel on skin, testosterone implants placed under skin etc.
Medical practitioner chooses appropriate treatment according to the health and age of patient. After starting the therapy, constant monitoring of testosterone level is necessary.
In case of infertile males due to hypogonadism, assisted reproductive therapy is useful. It is a modern medical approach which helps in conception.
Studies have shown that testosterone level is low in people suffering from type 2 diabetes and obese individuals. Controlling blood sugar and maintaining healthy weight will help to increase testosterone level in males.