Hypogonadism causes, symptoms, & treatment

Hypogonadism: Causes, Symptoms, Diagnosis, and Treatment

What Is Hypogonadism?

Hypogonadism occurs when a person’s organs fail to produce an adequate amount of sex hormones, often resulting in predictable symptoms. In men, the sex hormone in question and master regulator of the endocrine system is testosterone. Testosterone is responsible for the development of male traits but its role goes far beyond that to virtually all cellular function. Men with low testosterone levels may experience unwanted changes in their body composition (the ratio of muscle to fat tissue), mood, immunity, cognitive function, and energy levels.


In this article, we explore the causes, symptoms, and treatments of hypogonadism, and how to manage low testosterone levels.

What Causes Hypogonadism?

Hypogonadism has many potential causes, some of which can start before birth.


There are two types of hypogonadism: primary and secondary. Primary hypogonadism occurs when testosterone levels are affected for a genetic reason or because of a direct insult to a man’s testes. Causes of primary hypogonadism may include the following:

  • Chemotherapy or radiation
  • Hemochromatosis
  • Impaired growth of sex organs during fetal development
  • Infections (such as mumps orchitis)
  • Klinefelter syndrome
  • Testicular injury

Secondary hypogonadism occurs when testosterone levels are affected by a problem in the specific parts of the brain that regulate testosterone production, namely the pituitary gland and hypothalamus. Causes of secondary hypogonadism may include the following:

  • Certain medications
  • Inflammation
  • Kallmann syndrome
  • Normal aging
  • Obesity
  • Pituitary pathology (such as a tumor)
  • Untreated sleep apnea
  • Environmental endocrine disruptors
  • Extreme or prolonged stress
  • Different kinds of medications

Men can experience both types of hypogonadism independently or they may have a mix over the course of a lifetime. It is normal for men to experience a degree of hypogonadism as they get older because testosterone production declines as the body ages. However, the only way to know the cause of hypogonadism for certain is to undergo a comprehensive medical evaluation with lab testing.

What Are the Symptoms of Hypogonadism?

Although the symptoms of hypogonadism can range depending on the underlying causes, adult men may experience the following symptoms:

  • Decreased body hair
  • Decreased energy level
  • Decreased fertility
  • Decreased libido
  • Decreased muscle and bone mass
  • Erectile dysfunction
  • Increased breast tissue (gynecomastia)
  • Mood swings or depression
  • Short-term memory loss
  • Trouble concentrating
  • Weight gain

How Is a Diagnosis of Hypogonadism Made?

To diagnose hypogonadism, a clinician will evaluate a patient with a full medical exam and then order a range of blood work that generally includes a complete blood count, a prostate-specific antigen test, a lipid panel, and a full hormone panel including total and free testosterone levels. It is important that clinicians differentiate between total and free testosterone because this can help determine the exact cause of a patient’s hypogonadism. Obtaining an accurate diagnosis is essential when it comes to proper treatment.

How Is Hypogonadism Treated?

The treatment of hypogonadism, whether primary or secondary, is generally addressed via testosterone replacement or another type of hormone therapy including boosting your body’s natural testosterone production. Low testosterone levels can be improved with testosterone that is given exogenously (from an external source), either in cream or injectable form. The system can also be rebooted and induced to produce more testosterone.

What Are the Benefits of Testosterone Optimization?

When testosterone is returned to a normal range, men may experience increased energy and improved quality of life. One of the secondary benefits of testosterone replacement may be its positive impact on the heart. Low testosterone levels have been linked with atherosclerosis, which is the development of arterial plaque; thus, by optimizing testosterone, men may reduce their risk of developing cardiovascular disease. Testosterone replacement may also positively affect conditions such as obesity, myocardial ischemia, diabetes, and depression.

How to Learn More About Hypogonadism Treatment

At Vitality RX®, concierge clinicians use a comprehensive panel of blood tests and our physicians consider a patient’s full health profile when creating an individualized testosterone optimization plan, which ranges from diet and lifestyle recommendations to custom vitamin programs to hormone replacement therapy. Men who suspect they may have hypogonadism or are looking for an evaluation can start with a consultation at Vitality RX®. We’re here to help.