Hypogonadism

What is it?

Hypogonadism is an endocrine disorder that occurs when the sex glands — the ovaries in women and the testes in men — do not produce sufficient amounts of sex hormones or do not function properly.

These hormones, mainly testosterone in men and estrogen and progesterone in women, play a fundamental role in sexual development, fertility, bone health, body composition, and overall well-being.

Hypogonadism can appear at any stage of life. When it develops before puberty, it can affect the development of secondary sexual characteristics. When it appears in adulthood, it usually causes sexual, reproductive, and metabolic alterations.

There are two main types:

• Primary hypogonadism, when the problem originates directly in the ovaries or testes.
• Secondary hypogonadism, when the alteration affects the hypothalamus or the pituitary gland, brain structures that control the function of the sex glands.

Endocrinology at Hospital Ascires Valencia

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Each case is individually assessed by our team of specialists in Endocrinology to diagnose hypogonadism with the highest accuracy and treat it with the best possible outcomes.

What are the symptoms?

Symptoms vary according to the age of onset, sex, and degree of hormonal deficiency.

In men

The most common symptoms include:

• Decreased sexual desire
• Erectile dysfunction
• Reduced fertility
• Fatigue or lack of energy
• Loss of muscle mass
• Increased body fat
• Decreased bone density.
• Reduced growth of beard and body hair.

The following may also occur:

• Mood alterations
• Difficulty concentrating
• Loss of physical strength

In women

The most common symptoms are:

• Menstrual irregularities
• Absence of menstruation (amenorrhea)
• Decreased libido
• Vaginal dryness.
• Hot flashes
• Mood changes
• Difficulty conceiving

In adolescents

When hypogonadism appears before puberty, it can cause:

• Delayed puberty
• Absence or incomplete development of secondary sexual characteristics
• Growth alterations

When to consult a specialist?

It is advisable to consult an Endocrinology specialist when:

• There is persistent decreased sexual desire
• Fertility problems arise
• Menstrual irregularities or absence of menstruation occur
• There is erectile dysfunction accompanied by other hormonal symptoms
• Persistent fatigue appears without an obvious cause
• Loss of muscle mass or bone density is observed
• There is a delay in pubertal development in adolescents

Early evaluation makes it possible to identify the cause of the disorder and establish appropriate treatment.

Causes and risk factors

The causes of hypogonadism are highly varied and depend on the area of the body affected.

Primary hypogonadism

May be due to:

• Genetic alterations
• Autoimmune diseases
• Testicular or ovarian trauma
• Chemotherapy or radiotherapy
• Infections
• Ovarian or testicular surgery

Secondary hypogonadism

May be related to:

• Diseases of the pituitary gland or hypothalamus
• Pituitary tumors
• Complex hormonal alterations
• Chronic diseases
• Obesity
• Determined medications.

Notable risk factors include:

• Advanced age
• Obesity
• Diabetes mellitus
• Chronic diseases
• Oncological treatments
• Family history of endocrine disorders

How is it diagnosed?

The diagnosis requires a complete clinical assessment and specific hormonal studies.

The evaluation usually includes:

• Detailed clinical history
• Physical examination
• Assessment of symptoms and personal history

The most common tests are:

Hormonal analyses

These allow measurement of:

• Testosterone in men.
• Estrogen in women
• Luteinizing hormone (LH)
• Follicle-stimulating hormone (FSH)
• Prolactin
• Other hormones related to endocrine function

Imaging tests

In certain cases, the following may be requested:

• Pituitary MRI
• Testicular ultrasound
• Gynecological ultrasound

Complementary studies

Depending on the situation, the following may be performed:

• Bone densitometry
• Genetic studies
• Fertility evaluation

An accurate diagnosis makes it possible to determine the origin of the problem and plan the most appropriate treatment.

How is it treated?

Treatment depends on the cause of hypogonadism, the patient’s age, and their reproductive goals.

Hormone replacement therapy

This consists of administering the hormones that the body produces insufficiently.

It may include:

• Testosterone in men.
• Estrogen and progesterone in women, when indicated.

The goal is to restore adequate hormone levels and improve symptoms.

Treatment of the underlying cause

When hypogonadism is related to other diseases, it is important to treat the problem causing it.

For example:

• Pituitary tumors
• Endocrine alterations
• Metabolic diseases

Fertility treatment

In patients who wish to have children, specific treatments may be used to stimulate reproductive function.

Follow-up by Endocrinology

The specialty of Endocrinology is essential to:

• Confirm the diagnosis
• Determine the cause of the disorder
• Adjust hormonal treatment
• Monitor the response to treatment
• Prevent possible complications

Periodic monitoring enables optimization of outcomes and ensures the long-term safety of treatment.

How is it prevented?

Prevention of hypogonadism is not always possible, particularly when the condition results from genetic factors or congenital diseases.

However, certain measures may help protect hormonal health:

• Maintaining a healthy weight
• Engaging in regular physical exercise
• Avoiding excessive tobacco and alcohol consumption
• Managing chronic conditions such as diabetes
• Attending regular medical check-ups when risk factors are present

In addition, early detection of hormonal alterations enables treatment to be initiated before significant complications arise.

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• Reviewed by the Endocrinology medical team.