What is hypogonadism?
Hypogonadism is a condition in which the body produces abnormally low levels of testosterone, stemming from either testicular failure (primary) or dysfunction in the pituitary gland or hypothalamus (secondary).
Hypogonadism occurs when the body fails to produce adequate testosterone, the primary male hormone responsible for sexual function, muscle mass, bone density, and mood regulation. Low testosterone can develop from problems at different stages of the hormonal system, which clinicians categorize into two main types.
Primary hypogonadism involves direct testicular failure. The testicles themselves do not produce sufficient testosterone even when signaled by the pituitary gland. Common causes include Klinefelter syndrome, prior injury or infection, certain medications, or age-related decline.
Secondary hypogonadism stems from dysfunction in the hypothalamus or pituitary gland, which normally trigger testosterone production. The testicles are usually capable of function but receive insufficient hormonal signals. Causes range from pituitary tumors to prolonged use of opioids or anabolic steroids.
Diagnosis typically involves blood tests measuring testosterone levels (usually drawn in the morning when levels are highest) and sometimes additional tests of other hormones like luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Persistently low testosterone readings combined with symptoms like reduced libido, erectile dysfunction, fatigue, or loss of muscle mass often prompt clinical evaluation. Finding the underlying cause determines whether treatment addresses the testicular dysfunction directly or the signaling system controlling it. Hormone therapy providers can evaluate your specific situation and develop an appropriate treatment plan.