Materiały źródłowe

• #1 Male hypogonadism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881

  Male hypogonadism means the testicles don’t produce enough of the male sex hormone testosterone. There are two basic types of hypogonadism: […] This type of hypogonadism also known as primary testicular failure originates from a problem in the testicles. […] This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland parts of the brain that signal the testicles to produce testosterone. […] Either type of hypogonadism can be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. At times, primary and secondary hypogonadism occur together. […] Common causes of primary hypogonadism include: […] Klinefelter syndrome. This condition results from a congenital abnormality of the sex chromosomes, X and Y.

• #1 Male Hypogonadism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532933/

  Male hypogonadism, acquired or congenital, can be caused by defects that interfere with the hypothalamic-pituitary-testicular axis. […] It is essential to distinguish between primary hypogonadism and secondary hypogonadism. […] Primary hypogonadism (testicular failure) is diagnosed by persistently low testosterone measurements with above-normal LH levels. Some causes of primary hypogonadism include Klinefelter syndrome, undescended testicles, mumps orchitis, hemochromatosis, cancer treatment, and normal aging. […] Secondary hypogonadism (pituitary failure) is characterized by low serum testosterone with normal or low LH levels. Causes of secondary hypogonadism include Kallman syndrome, pituitary disorders, HIV, obesity, surgery, trauma, and stress-induced hypogonadism. […] Both primary and secondary hypogonadism can cause significant abnormalities in sperm count and semen analyses.

• #1 Male hypogonadism – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881

  Undescended testicles. […] Mumps orchitis. […] Hemochromatosis. […] Injury to the testicles. […] Cancer treatment. […] In secondary hypogonadism, the testicles are normal but don’t function properly due to a problem with the pituitary or hypothalamus. A number of conditions can cause secondary hypogonadism, including: […] Kallmann’s syndrome. […] Pituitary disorders. […] Inflammatory disease. […] HIV/AIDS. […] Medications. […] Obesity. […] Aging.

• #1 Table: Causes of Hypogonadism*-Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/multimedia/table/causes-of-hypogonadism

  Causes of Hypogonadism […] Type […] Congenital Causes […] Acquired Causes […] Primary (testicular) […] Klinefelter syndrome […] Anorchia (bilateral) […] Cryptorchidism […] Myotonic dystrophy […] Enzymatic defects in testosterone synthesis […] Leydig cell aplasia […] Noonan syndrome […] Chemotherapy or radiation therapy […] Testicular infection (eg, mumps, echovirus, flavivirus) […] Trauma […] High doses of antiandrogen medications (eg, cimetidine, spironolactone, ketoconazole, flutamide, cyproterone) […] […] Secondary (hypothalamic-pituitary) […] Idiopathic hypogonadotropic hypogonadism […] Kallmann syndrome (idiopathic hypogonadotropic hypogonadism with anosmia) […] Prader-Willi syndrome […] Dandy-Walker malformation […] Isolated luteinizing hormone deficiency

• #1 Hypogonadism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/922038-overview

  Hypogonadotropic hypogonadism can result from the following: Central nervous system (CNS) disorders – Including tumors and miscellaneous causes involving the pituitary/hypothalamic area […] Genetic causes – Eg, Kallmann syndrome […] Congenital disorders – Eg, Prader-Willi syndrome, Laurence-Moon syndrome, Bardet-Biedl syndrome, and Gaucher disease […] Acquired disorders – Eg, exercise-induced hypogonadism, psychogenic hypogonadism, hyperprolactinemia, Cushing syndrome, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), morbid obesity, type II diabetes mellitus. […] Causes of hypergonadotropic hypogonadism (primary hypogonadism) in males include the following: Klinefelter syndrome […] Inactivating mutation […] Chemotherapy […] Radiation therapy […] Gonadectomy […] Anorchism and cryptorchidism […] Testicular biosynthetic defects – 17-hydroxylase dehydrogenase deficiency, 5-reductase deficiency, 17-hydroxylase deficiency […] Defects in testicular determination – Gonadal dysgenesis […] Other rare disorders of sex development (DSDs) – Ovotesticular DSD, XX males […] Sertoli-cell-only syndrome […] LH resistance.

• #1 Male Hypogonadism: Causes, Symptoms, and Treatment

  https://www.verywellhealth.com/male-hypogonadism-8651069

  Male hypogonadism is a deficiency in the sex hormone testosterone in adult males and male children. Also known as testosterone deficiency or „low T,” male hypogonadism can be caused by conditions affecting the testicles (which produce the hormone in males) or conditions affecting the hypothalamus or pituitary gland (which regulates the production of testosterone). […] In males, hypogonadism occurs either because the testicles are not functioning normally or because the hypothalamus and/or pituitary gland are not functioning normally. […] Primary hypogonadism is caused by a defect of the testicles. The defect can be due to congenital causes (meaning conditions you are born with) and acquired causes (conditions you develop later in life). […] Congenital causes of primary hypogonadism include: Cryptorchidism: Also known as undescended testicles, Disorders of sex development: A sexual developmental variation also known as intersex, Down syndrome: A genetic disorder specifically affecting the chromosome 21, Klinefelter’s syndrome: A chromosomal disorder affecting only males, Myotonic dystrophy: A muscle weakness disorder closely linked to hypogonadism.

• #1 Causes of primary hypogonadism in males – UpToDate

  https://www.uptodate.com/contents/causes-of-primary-hypogonadism-in-males

  Causes of primary hypogonadism in males […] Congenital abnormalities include Klinefelter syndrome, other chromosomal abnormalities, mutation in the FSH and LH receptor genes, cryptorchidism, disorders of androgen biosynthesis, myotonic dystrophy, congenital anorchia, and varicocele. […] Acquired diseases include infections, radiation, alkylating and antineoplastic agents, ketoconazole, glucocorticoids, environmental toxins (endocrine-disrupting chemicals), trauma, testicular torsion, bilateral orchiectomy, autoimmune damage, and chronic systemic diseases such as cirrhosis, chronic kidney disease, and HIV. […] The distinction between primary and secondary hypogonadism is made by measurement of the serum concentrations of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

• #1 Hypogonadism – Wikipedia

  https://en.wikipedia.org/wiki/Hypogonadism

  Examples of congenital causes of hypogonadism, that is, causes that are present at birth: Turner syndrome and Klinefelter syndrome. […] Examples of acquired causes of hypogonadism: Opioid-induced androgen deficiency (resulting from the prolonged use of opioid-class medications, e.g. codeine, Dihydrocodeine, morphine, oxycodone, methadone, fentanyl, hydromorphone, etc.). […] In males, normal aging causes a decrease in androgens, which is sometimes called „male menopause” (also known by the coinage „manopause”), late-onset hypogonadism (LOH), and „andropause” or androgen decline in the aging male (ADAM), among other names. […] Hypogonadism can involve just hormone production or just fertility, but most commonly involves both. […] Examples of hypogonadism that affect hormone production more than fertility are hypopituitarism and Kallmann syndrome; in both cases, fertility is reduced until hormones are replaced but can be achieved solely with hormone replacement. […] Examples of hypogonadism that affect fertility more than hormone production are Klinefelter syndrome and Kartagener syndrome.

• #1 Male Hypogonadism: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/male-hypogonadism.html

  Hypogonadism is an endocrine dysfunction leading to testosterone deficiency. […] Primary hypogonadism is caused by a disorder of testicular testosterone production; the releasing hormones are compensatory increased (hypergonadotropic hypogonadism). […] Secondary hypogonadism is caused by a disturbance of pituitary releasing hormones (hypogonadotropic hypogonadism). […] Hypergonadotropic hypogonadism results from bilateral diseases of the testes, diseases of a solitary testis, or from a disorder of testosterone biosynthesis. […] Congenital diseases: Klinefelter syndrome (47,XXY), disorders of sex development such as 46,XX male syndrome, disorders of testosterone biosynthesis, or anorchidia (vanishing testis syndrome). […] Acquired conditions: Testicular cancer (especially after chemotherapy), testicular torsion, testicular trauma, orchitis, or late-onset hypogonadism.

• #1 Low Testosterone (Low T): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadism

  Congenital conditions that can lead to secondary hypogonadism include: Isolated hypogonadotropic hypogonadism (a condition that causes low levels of gonadotropin-releasing hormone from birth) and Kallmann syndrome (a rare genetic condition that causes loss of the development of nerve cells in your hypothalamus that produce gonadotrophin-releasing hormone). […] Acquired conditions that can lead to secondary hypogonadism include: Hypopituitarism (This condition may result from an adenoma, infiltrative disease, infection, injury, radiation therapy or surgery that affects your pituitary gland).

• #1 Hypogonadism: Types, Causes, Symptoms, Treatment, Outlook

  https://www.healthline.com/health/hypogonadism

  Hypogonadism occurs when the sex glands produce little to no sex hormones. […] The causes of primary hypogonadism include: autoimmune diseases such as Addisons disease and hypoparathyroidism, genetic disorders such as Turner syndrome and Klinefelter syndrome, inflammation or mumps involving the testicles or ovaries, undescended testes, liver and kidney diseases, surgery on your sexual organs, radiation exposure. […] Secondary hypogonadism may be the result of the following: genetic disorders such as Kallmann syndrome (abnormal hypothalamic development), injury to your hypothalamus or pituitary gland, a tumor in or near your pituitary gland, pituitary disorders, infections, including HIV, inflammatory diseases such as sarcoidosis and tuberculosis, obesity, rapid weight loss, nutritional deficiencies, use of steroids or opioids, brain surgery, radiation exposure, hemochromatosis, which occurs when your body absorbs too much iron. […] Eugonadotropic hypogonadism may be caused by: delayed menarche, polycystic ovary syndrome (PCOS), hyperprolactinemia, or excess amounts of the hormone prolactin.

• #1 Hypogonadism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/922038-overview

  In 1944, Kallmann and colleagues first described familial isolated gonadotropin deficiency. Recently, many other genetic causes for hypogonadotropic hypogonadism have been identified. Normosmic hypogonadotropic hypogonadism, in which the sense of smell is not disrupted, has been associated with mutations in GNRH1, KISS1R, and GNRHR genes. Although their exact functions are unclear, the genes TAC3 and TACR3 have also been associated with normosmic hypogonadotropic hypogonadism. Kallmann syndrome (anosmic hypogonadotropic hypogonadism) has been associated with mutations in KAL1, FGFR1, FGF8, PROK2, and PROKR2 genes. The relationship with Kallmann syndrome is thought to be because these genes are all related to the development and migration of GnRH neurons. Mutations of an additional gene, CHD7, which has been associated with CHARGE syndrome, has also been found in patients with normosmic or anosmic hypogonadotropic hypogonadism.

• #1 Male hypogonadism – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/male-hypogonadism

  Congenital causes of secondary male hypogonadism include Kallmann syndrome, normosmic congenital hypogonadotropic hypogonadism, CHARGE syndrome, Waardenburg syndrome, congenital adrenal hypoplasia, and septo-optic dysplasia. […] Mixed male hypogonadism results from both disorders of the testes (primary) and the hypothalamus and/or pituitary gland (secondary). Acquired causes include heavy alcohol use, chronic diseases (e.g., HIV, IBD, post-COVID-19 condition, celiac disease), and organ failure (e.g., heart failure, chronic kidney disease, cirrhosis). Congenital causes include congenital adrenal hyperplasia and Prader-Willi syndrome.

• #1 Table: Causes of Hypogonadism*-Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/multimedia/table/causes-of-hypogonadism

  Any acute systemic illness […] Hypopituitarism (tumor, infarction, infiltrative disease, infection, trauma, irradiation or pituitary surgery) […] Hyperprolactinemia […] Iron overload (hemochromatosis) […] Certain medications and drugs (eg, estrogens, psychoactive drugs, metoclopramide, opioids, leuprolide, goserelin, triptorelin, some androgen biosynthesis inhibitors for prostate cancer) […] […] Cushing syndrome […] Cirrhosis […] Obesity […] Idiopathic […] Mixed […] Aging […] Alcohol use disorder […] Systemic disease (eg, uremia, liver failure, severe HIV infection, sickle cell disease) […] Medications (eg, corticosteroids)

• #1 Male hypogonadism: Symptoms and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3255409/

  The use of certain drugs, such as, opiate pain medications and some hormones, can affect testosterone production. […] Being significantly overweight at any age may be linked to hypogonadism. […] Stress, excessive physical activity, and weight loss have all been associated with hypogonadism. […] Recent studies have found that testosterone production slowly decreases as a result of aging, although the rate of decline varies. […] The proposed causes for the effects of obesity on testosterone level include increased clearance or aromatization of testosterone in the adipose tissue and increased formation of inflammatory cytokines, which hinder the secretion of the gonadotropin-releasing hormone. […] Although diabetes mellitus-related hypogonadism was previously thought to be associated with testicular failure, study results show one-third of diabetic men had low testosterone levels, but also had low pituitary hormone levels. […] Certain medications are shown to reduce testosterone production.

• #1 Hypogonadism: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001195.htm

  Hypogonadism occurs when the body’s sex glands (gonads) produce little or no hormones. In men, these glands are the testes. In women, these glands are the ovaries. […] The cause of hypogonadism can be primary (testes or ovaries) or secondary (problem with the pituitary or hypothalamus). In primary hypogonadism, the ovaries or testes themselves do not function properly. Causes of primary hypogonadism include: Certain autoimmune disorders, Genetic and developmental disorders, Infection, Iron excess (hemochromatosis), Liver and kidney disease, Radiation (to the gonads), Surgery, Trauma. […] In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Causes of central hypogonadism include: Anorexia nervosa, Bleeding in the area of the pituitary, Taking medicines, such as glucocorticoids and opiates, Stopping anabolic steroids, Genetic problems, Infections, Nutritional deficiencies, Iron excess (hemochromatosis), Radiation (to the pituitary or hypothalamus), Rapid, significant weight loss (including weight loss after bariatric surgery), Surgery (skull base surgery near the pituitary), Trauma, Tumors.

• #1 Hypogonadism and Health Implications in Men and Women

  https://www.verywellhealth.com/hypogonadism-8784748

  Undescended testicles (cryptorchidism). […] Causes of secondary hypogonadism include: […] Genetic disorders such as Kallmann syndrome, which affects the normal development of the hypothalamus […] Pituitary tumors, such as prolactinomas which secrete excessive amounts of prolactin (a hormone that interferes with the production of estrogen and testosterone) […] Chronic infections like human immunodeficiency virus (HIV), which exposes the hypothalamus and pituitary gland to damaging inflammation […] Inflammatory diseases like sarcoidosis and tuberculosis that directly damage the hypothalamus and pituitary gland […] Traumatic brain injuries (TBIs) that injure the hypothalamus and pituitary gland […] Brain surgery or radiation […] Diabetes, which can affect the hypothalamus and pituitary due to insulin resistance

• #1 Male Hypogonadism: Causes, Symptoms, and Treatment

  https://www.verywellhealth.com/male-hypogonadism-8651069

  Congenital causes of secondary hypogonadism include: Gonadotropin-releasing hormone (GnRH) deficiency: A genetic disorder that causes low levels of GnRH hormone, which stimulates testosterone production, Hereditary hemochromatosis: A genetic disorder that causes the accumulation of iron, which can damage the hypothalamus and pituitary gland, Kallmann syndrome: A genetic disorder affecting the hypothalamus that causes delayed or absent puberty in people of any sex. […] Acquired causes of secondary hypogonadism include: Certain medications: Including corticosteroids, opioids, statins, estrogens, and GnRH analogs that directly or indirectly suppress parts of the HPA axis, Chronic diseases: Like human immunodeficiency virus (HIV), coronary artery disease, type 2 diabetes, or chronic kidney disease that disrupt communications in the HPA axis, Excessive exercise: Which increases the production of cortisol, the stress hormone that directly suppresses testosterone production, Inflammatory diseases: Including sarcoidosis, histiocytosis, and tuberculosis that can directly affect the hypothalamus and pituitary gland, Metabolic disorders: Like obesity and metabolic syndrome that increase the production of enzymes called aromatase that transform testosterone into estrogen, Malnutrition: Including severe wasting (cachexia) and eating disorders like anorexia nervosa, Pituitary tumors: Including benign pituitary adenomas or brain tumors that affect the pituitary gland (including benign meningiomas or cancerous gliomas).

• #1 What Is Low Testosterone and What Causes It? – Richmond University Medical Center

  https://www.rumcsi.org/news/what-causes-low-testosterone/

  Acquired conditions that can cause secondary hypogonadism include: Brain injury or head trauma, Certain medications, Kidney failure, Cushings syndrome (a condition caused by too much cortisol in the body), Liver damage, Hemochromatosis (iron overload), Hyperprolactinemia (abnormally high levels of prolactin).

• #1 Hypogonadism and Health Implications in Men and Women

  https://www.verywellhealth.com/hypogonadism-8784748

  Pituitary disorders, including Cushing’s syndrome and diabetes insipidus […] Obstructive sleep apnea, in which decreased blood oxygen from breathing gaps impairs hypothalamus function […] Nutritional deficiencies, such as vitamin C, D, B1, and B12, which aid in nerve signaling and the normal function of the hypothalamus […] Eating disorders like anorexia nervosa that cause malnutrition […] Obesity, in which fatty tissues release excessive amounts of the enzyme aromatase that converts testosterone into estrogen […] Medications like opioids and anabolic steroids that disrupt communications between the hypothalamus and pituitary gland […] Hemochromatosis (iron overload) which overwhelms the hypothalamus and pituitary gland with iron deposits. […] Primary hypogonadism occurs when the testes or ovaries do not function properly, and secondary hypogonadism occurs when the hypothalamus or pituitary gland does not work properly.

• #1 Male hypogonadotropic hypogonadism: Meaning, Treatment & Causes

  https://www.trted.org/articles/hypogonadotropic-hypogonadism-the-complete-guide

  Another cause that’s receiving more attention recently is functional hypogonadotropic hypogonadism. This type of hypogonadotropic hypogonadism is diagnosed once other obvious causes have been ruled out. The hypothalamus and/or the pituitary are affected, but the reason why is unclear. […] However, more recent evidence suggests that type 2 diabetes and obesity are involved. Infections like HIV, low energy availability, and different drugs may also have an impact.

• #1 Male hypogonadism: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/307634

  In secondary hypogonadism, a disease state interferes with either the hypothalamus or pituitary gland, the main glands that release hormones to stimulate the testes to produce testosterone. […] Situations that can cause secondary hypogonadism include: malnutrition, systemic illness, stress, medication side effects, liver cirrhosis, toxins (alcohol and heavy metals), morbid obesity. […] Risk factors for hypogonadism include type 2 diabetes, obesity, renal failure, HIV, hypertension, chronic obstructive pulmonary disease (COPD) and taking glucocorticoid (steroids), opioid or antipsychotic medication therapy.

• #1 Male hypogonadism | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/

  Male hypogonadism is the result of deficiency of the male sex hormone testosterone. […] Male hypogonadism can be divided into two groups. Classical hypogonadism is where the low levels of testosterone are caused by an underlying specific medical condition, for example Klinefelter’s syndrome, Kallmanns syndrome or a pituitary tumour. Late-onset hypogonadism is where the decline in testosterone levels is linked to general ageing and/or age-related diseases. Additionally, obesity and type 2 diabetes can be associated with hypogonadism in men. […] There are two types of classical male hypogonadism primary and secondary. Primary hypogonadism occurs when the low level of testosterone is due to conditions affecting the testes. […] Secondary hypogonadism occurs when signalling to the testis is unable to stimulate sufficient testosterone production and is caused by conditions affecting the function of the hypothalamus and/or pituitary gland.

• #1 Male Hypogonadism: A Review of the Disease and Its Treatment

  https://www.uspharmacist.com/article/male-hypogonadism-a-review-of-the-disease-and-its-treatment

  Male hypogonadism is defined as a testicular dysfunction resulting in decreased sperm and testosterone production. This disorder is not uncommon and frequently goes undiagnosed due to the nonspecific clinical presentation of the disease. However, male hypogonadism has been described in up to 20% of men over the age of 70 years and has been reported in 4% of all men. Trends demonstrating higher frequency of males affected by this disorder may be related to increased life expectancy, as rates of hypogonadism increase with age. In addition, the growing numbers of Americans who are overweight and who develop type 2 diabetes mellitus have also been described as potential causes for the increasing prevalence. Recent data have suggested that up to one-third of men with a diagnosis of type 2 diabetes and a body mass index (BMI) of 30 kg/m2 have hypogonadism defined by a low serum-free testosterone level. The cause for reduced androgen levels in these patients is unclear; however, there have been some proposed mechanisms for this observation.

• #1 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  There is a high prevalence of LOH within specific populations, including patients with obesity, type 2 diabetes (T2DM), metabolic syndrome (MetS), cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), renal disease and cancer. In particular low testosterone levels are relatively common in men with T2DM and in those with metabolic derangements. […] Klinefelter syndrome, a trisomy associated with a 47,XXY karyotype, is the most prevalent genetic cause of primary hypogonadism, with a global prevalence of 1/500-1,000 live male births. However, 50% of individuals with Klinefelter syndrome are diagnosed during their lifetime. […] Male hypogonadism can be classified according to the aetiology into primary hypogonadism or secondary hypogonadism. A compensated or subclinical form of hypogonadism, characterised by normal testosterone serum levels and elevated luteinising hormone (LH) production, has also been reported; the clinical significance of this condition is unclear.

• #1 Acquired Causes of Secondary Hypogonadism in the Adult Male – Hypogonadism

  https://www.medpagetoday.com/resource-centers/hypogonadism/acquired-causes-secondary-hypogonadism-adult-male-/1105

  Secondary hypogonadism, often called hypogonadotropic hypogonadism, may be due to many common medical conditions and some drugs. Obesity and diabetes are two common conditions linked to secondary hypogonadism. As with other acquired causes of hypogonadism, treatment of the underlying disease may improve symptoms caused by androgen deficiency. […] Two-thirds of Americans are overweight and one-third are obese, so it is important to understand the possible relationship between obesity and secondary hypogonadism. Obesity may be related to suppression of the gonadotropins LH and FSH secreted by the pituitary gland. Additionally, increased conversion of testosterone to estradiol by aromatase is common in adipocytes, leading to greater feminizing and decreased androgenic features as obesity becomes more severe.

• #1 Male hypogonadism | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/

  Male hypogonadism does not run in families. There are genetic causes of hypogonadism, which include Klinefelters syndrome and Kallmanns syndrome; however, these conditions occur sporadically, they are not inherited from the parents. […] Male hypogonadism has been linked with an increased risk of developing heart disease (low testosterone can cause an increase in cholesterol levels). Studies have shown that testosterone levels can be lower in men with type 2 diabetes and in men with excess body weight. However, it is not clear whether this is an association or a direct cause and effect.

• #1 Assessment and management of male androgen disorders: an update

  https://www.racgp.org.au/afp/2014/may/male-androgen-disorders

  Organic congenital causes of secondary hypogonadism are rare and include Kallmann syndrome, GnRH receptor mutation and deficiency, or genetic mutations associated with other pituitary hormone deficiencies. […] Many chronic diseases are associated with low testosterone levels via suppression of gonadotropin production. Testosterone levels are commonly lowered in men with metabolic syndrome, type 2 diabetes mellitus, obesity, depression, obstructive sleep apnoea, chronic kidney disease or anorexia nervosa. […] Hyperprolactinaemia can lead to secondary hypogonadism through suppression of the pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. […] In the work-up for secondary hypogonadism, it is very important not to miss pituitary or hypothalamic pathology, which can damage gonadotroph production, resulting in hypogonadism.

• #1 Male hypogonadism | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/

  Examples of conditions affecting the testes, which lead to primary gonadal failure, include: inflammation due to infections such as mumps, chemotherapy or radiotherapy to the testes, failure of the testes to descend into the scrotum, absence of the testes (anorchidism), Klinefelters syndrome a genetic condition in which men are born with an extra X chromosome; characterised by tall stature, reduced fertility, and development of breast tissue, certain types of tumours, certain types of autoimmune. […] Examples of causes can include: pituitary tumours and their treatment, isolated hypogonadotrophic hypogonadism (low levels of gonadotrophin-releasing hormone from birth), Kallmanns syndrome a rare genetic condition, which causes loss of the development of nerve cells in the hypothalamus that produce gonadotrophin-releasing hormone.

• #1 Assessment and management of male androgen disorders: an update

  https://www.racgp.org.au/afp/2014/may/male-androgen-disorders

  Male hypogonadism, caused by intrinsic pathology of the hypothalamicpituitarytesticular (HPT) axis, is an under-diagnosed condition not to be missed. […] This article outlines the aetiology, clinical features, investigation and management of male hypogonadism and discusses the more controversial area of LOH. […] Once the low testosterone value has been confirmed on repeated morning measurements in patients with consistent symptoms and signs, luteinizing hormone (LH) and follicle stimulating hormone (FSH) values should be obtained to further distinguish between primary or secondary hypogonadism. Elevated LH and FSH values indicate primary (testicular) hypogonadism, whereas low or importantly even inappropriately normal LH and FSH values may indicate secondary (pituitaryhypothalamic) hypogonadism.

• #1 Assessment and management of male androgen disorders: an update

  https://www.racgp.org.au/afp/2014/may/male-androgen-disorders

  The practitioner needs to be aware that men with prior or current anabolic steroid use may present with low testosterone and LH levels and use may be denied even with specific questioning. […] It is very important to remember that an underlying aetiology should always be sought before testosterone therapy is considered. […] Testosterone replacement is recommended for symptomatic classical androgen deficiency syndromes after excluding contraindications in the initial work up. […] Older obese men with chronic comorbidities commonly present with non-specific symptoms and modestly low testosterone. […] The risk-benefit ratio of testosterone therapy in such men is less favourable than in men with organic androgen deficiency. […] Large, well-conducted clinical trials are needed to provide more evidence to guide clinicians and patients regarding the benefits, and risks, of testosterone therapy.

• #1 Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/

  Several treatment options exist for testosterone replacement, including oral preparations of testosterone derivatives; intramuscular injections of long-acting testosterone esters; transdermal patches applied to the scrotum or other areas of the body (eg, upper arms, legs, abdomen, or back); and a recently approved 1% testosterone gel. […] Testosterone replacement therapy can return hormone levels to normal ranges and help alleviate the symptoms associated with hypogonadism.

• #1 Low Testosterone (Testosterone Deficiency): Symptoms and Treatment

  https://patient.info/mens-health/erectile-dysfunction-impotence/testosterone-deficiency

  Low testosterone can also be caused by a problem with parts of the brain (hypothalamus and pituitary gland) which make the hormones that stimulate the testicles to make testosterone. This is sometimes called secondary testosterone deficiency. […] A number of conditions can cause secondary testosterone deficiency, including: Pituitary gland disorders such as a benign tumour called a prolactinoma. […] Testosterone deficiency can be identified by blood tests which might be suggested when describing decreased sex drive (reduced libido) or erectile dysfunction. […] The treatment for low testosterone also depends on the underlying cause. […] If low testosterone is caused by a pituitary gland problem, treatment with pituitary hormones may stimulate sperm production and improve fertility. Testosterone replacement therapy can be used. […] If a pituitary tumour is the cause of low testosterone then this will require treatment, such as surgical removal, chemotherapy or radiotherapy, as well as replacement therapy with other hormones.

• #1 Male Hypogonadism – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/male-reproductive-endocrinology-and-related-disorders/male-hypogonadism

  Primary hypogonadism involves failure of the testes to respond to follicle-stimulating hormone (FSH) and luteinizing hormone (LH). […] The most common genetic cause of primary hypogonadism is Klinefelter syndrome. […] Secondary hypogonadism is failure of the hypothalamus to produce gonadotropin-releasing hormone (GnRH), as in idiopathic hypogonadotropic hypogonadism, or of the pituitary gland to produce enough FSH and LH. […] Any acute systemic illness can cause temporary secondary hypogonadism. […] Some syndromes of hypogonadism have both primary and secondary causes (mixed hypogonadism). […] The table Causes of Hypogonadism lists some common causes of hypogonadism by category. […] Infertility due to primary hypogonadism does not generally respond to hormonal therapy. […] Infertility due to secondary hypogonadism usually responds to gonadotropin replacement therapy. […] Most men who have secondary hypogonadism due to a hypothalamic defect (eg, idiopathic hypogonadotropic hypogonadism, Kallmann syndrome) become fertile with treatment despite sperm counts that are low (eg, 5 million/mL).

• #1 Hypogonadism in males – Symptoms, Causes, Images, and Treatment Options

  https://www.epocrates.com/online/diseases/1093/hypogonadism-in-males

  Hypogonadism in men may present with reproductive/sexual clinical features (e.g., incomplete pubertal development, infertility, gynecomastia), as well as nonreproductive features (e.g., fatigue, osteoporosis, loss of motivation or concentration, irritability, low or labile mood, body image concerns). […] Measurement of the gonadotropins (luteinizing hormone [LH], follicle stimulating hormone [FSH]) distinguishes between a primary cause (dysfunction of the testes) and a secondary (also known as central or hypogonadotropic) cause (pituitary or hypothalamic dysfunction). […] Management of men with low testosterone due to nongonadal illness (e.g., obesity) is to optimize treatment of the underlying condition.

• #1 Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/

  Some investigators believe that replacing DHEA in patients with low libidos and normal or borderline testosterone is an important component of treatment to restore sexual desire and performance. […] The goal of testosterone replacement therapy is to provide and maintain a normal level of testosterone, thereby restoring libido and improving erectile function; improving mood and providing a sense of well-being; decreasing fatigue; and improving lean body mass, strength and stamina. […] Testosterone treatment may stimulate tumor growth in androgen-dependent cancers and is therefore contraindicated in men with breast or prostate cancer. Some experts believe, however, that it may be used judiciously in men who are cured of prostate cancer when the benefits clearly outweigh the risks. […] In addition to the absolute contraindications, relative contraindications for testosterone replacement are sleep apnea and benign prostatic hypertrophy (BPH). Some experts believe that high cholesterol levels and hematologic abnormalities should also be considered relative contraindications to hormone therapy.

• #1 Low Testosterone (Male Hypogonadism) | UNC Men’s Health Program

  https://www.med.unc.edu/menshealth/low-testosterone-male-hypogonadism/

  Low testosterone (male hypogonadism) is a condition in which the testicles do not produce enough testosterone (the male sex hormone). […] There are many other potential causes of low testosterone including: Injury or infection of the testes, Chemotherapy treatment, Metabolic disorders such as hemochromatosis, Dysfunction or tumors of the pituitary gland, Medications such as opioids, hormones used to treat prostate cancer, and steroids, Illness, Alcohol abuse, Cirrhosis of the liver, Chronic kidney failure, HIV/AIDS, Inflammatory conditions such as sarcoidosis, Kallman syndrome, Klinefelter syndrome, also called XXY syndrome. […] Other men who should not take testosterone replacement therapy include those who have: An enlarged prostate, A lump on their prostate that has not been evaluated, A PSA measurement above 4, Breast cancer, An elevated hematocrit level, Severe congestive heart failure, Obstructive sleep apnea that has not been treated.

• #1 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  Male hypogonadism is a clinical syndrome which comprises of symptoms with or without signs and biochemical evidence of testosterone deficiency. Hypogonadism is associated with decreased testicular function and production of androgens and/or impaired sperm production. This may be caused by impaired testicular function (hypergonadotropic hypogonadism or primary hypogonadism) or as a result of inadequate stimulation of the testes by the hypothalamic-pituitary axis (hypogonadotropic hypogonadism or secondary hypogonadism) or uncommonly by reduced ability of testosterone to stimulate the androgen receptor at the cellular level. Hypogonadism can adversely affect multiple organ functions and quality of life (QoL). […] The prevalence of LOH increases with age, with the major causes being obesity, other co-morbidities (e.g., diabetes) and overall poor health. The incidence of hypogonadism has been reported to be between 12.3 and 11.7 cases per 1,000 people per year. Aging accounts for a low percentage of hypogonadism, as there is only a small gradual decline in testosterone, up to the age of 80 years, in healthy aging men. In men aged 40-79 years, the incidence of symptomatic hypogonadism varies between 2.1 and 5.7%.

• #1 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  The classification of hypogonadism has also been divided into two broad categories: Classical/Organic and Functional, often but not correctly identified as LOH. The clinical effects of testosterone deficiency are however common to all patients independent of the cause of the hypogonadism; although, they may vary in severity or as a result of age of onset. […] Finally, hypogonadism can also result from several conditions leading to reduced sensitivity/insensitivity to testosterone and its metabolites. […] The current guidelines maintain a classification of Primary and Secondary Hypogonadism, with special reference to LOH. The classification, based on the aetiology of hypogonadism, allows clinicians to adequately select appropriate treatment. In patients with secondary hypogonadism, both fertility and testosterone normalisation can be theoretically achieved with adequate treatment, whereas in primary hypogonadism only testosterone therapy can be considered, which eventually impairs fertility due to suppression of the HPT axis.

• #1 Hypogonadism in males

  https://dermnetnz.org/topics/hypogonadism-in-males

  Acquired secondary hypogonadism may result from: Damage to the pituitary or hypothalamus, including: Intracranial space-occupying lesions (eg, tumours and cysts), Infiltrative disease (eg, sarcoidosis and haemochromatosis), Infection (eg, meningitis), Pituitary apoplexy (bleeding into pituitary gland), Trauma. […] The diagnosis of hypogonadism is based on observing typical clinical features in a man with low serum testosterone. […] Effective testosterone replacement in men with hypogonadism has been showed to maintain secondary sexual characteristics, increase libido, muscle strength, fat-free mass, and bone density.

• #2 Male Hypogonadism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK532933/

  Male hypogonadism, acquired or congenital, can be caused by defects that interfere with the hypothalamic-pituitary-testicular axis. […] It is essential to distinguish between primary hypogonadism and secondary hypogonadism. […] Primary hypogonadism (testicular failure) is diagnosed by persistently low testosterone measurements with above-normal LH levels. Some causes of primary hypogonadism include Klinefelter syndrome, undescended testicles, mumps orchitis, hemochromatosis, cancer treatment, and normal aging. […] Secondary hypogonadism (pituitary failure) is characterized by low serum testosterone with normal or low LH levels. Causes of secondary hypogonadism include Kallman syndrome, pituitary disorders, HIV, obesity, surgery, trauma, and stress-induced hypogonadism. […] Both primary and secondary hypogonadism can cause significant abnormalities in sperm count and semen analyses.

• #2 Hypogonadism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/922038-overview

  Hypogonadotropic hypogonadism can result from the following: Central nervous system (CNS) disorders – Including tumors and miscellaneous causes involving the pituitary/hypothalamic area […] Genetic causes – Eg, Kallmann syndrome […] Congenital disorders – Eg, Prader-Willi syndrome, Laurence-Moon syndrome, Bardet-Biedl syndrome, and Gaucher disease […] Acquired disorders – Eg, exercise-induced hypogonadism, psychogenic hypogonadism, hyperprolactinemia, Cushing syndrome, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), morbid obesity, type II diabetes mellitus. […] Causes of hypergonadotropic hypogonadism (primary hypogonadism) in males include the following: Klinefelter syndrome […] Inactivating mutation […] Chemotherapy […] Radiation therapy […] Gonadectomy […] Anorchism and cryptorchidism […] Testicular biosynthetic defects – 17-hydroxylase dehydrogenase deficiency, 5-reductase deficiency, 17-hydroxylase deficiency […] Defects in testicular determination – Gonadal dysgenesis […] Other rare disorders of sex development (DSDs) – Ovotesticular DSD, XX males […] Sertoli-cell-only syndrome […] LH resistance.

• #2 Male hypogonadism | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/male-hypogonadism

  Male hypogonadism means the testicles don’t produce enough of the male sex hormone testosterone. There are two basic types of hypogonadism: Primary. This type of hypogonadism also known as primary testicular failure originates from a problem in the testicles. Secondary. This type of hypogonadism indicates a problem in the hypothalamus or the pituitary gland parts of the brain that signal the testicles to produce testosterone. Either type of hypogonadism can be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. At times, primary and secondary hypogonadism occur together. […] Common causes of primary hypogonadism include: Klinefelter syndrome. This condition results from a congenital abnormality of the sex chromosomes, X and Y. A male normally has one X and one Y chromosome. In Klinefelter syndrome, two or more X chromosomes are present in addition to one Y chromosome. The extra X chromosome that occurs in Klinefelter syndrome causes abnormal development of the testicles, which in turn results in underproduction of testosterone.

• #2 Male hypogonadism | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/male-hypogonadism

  Undescended testicles. Before birth, the testicles develop inside the abdomen and normally move down into their permanent place in the scrotum. Sometimes one or both of the testicles aren’t descended at birth. This condition often corrects itself within the first few years of life without treatment. If not corrected in early childhood, it can lead to malfunction of the testicles and reduced production of testosterone. […] Mumps orchitis. A mumps infection involving the testicles that occurs during adolescence or adulthood can damage the testicles, affecting the function of the testicles and testosterone production. […] Hemochromatosis. Too much iron in the blood can cause testicular failure or pituitary gland dysfunction, affecting testosterone production. […] Injury to the testicles. Because they’re outside the abdomen, the testicles are prone to injury. Damage to both testicles can cause hypogonadism. Damage to one testicle might not impair total testosterone production.

• #2 Table: Causes of Hypogonadism*-Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/multimedia/table/causes-of-hypogonadism

  Causes of Hypogonadism […] Type […] Congenital Causes […] Acquired Causes […] Primary (testicular) […] Klinefelter syndrome […] Anorchia (bilateral) […] Cryptorchidism […] Myotonic dystrophy […] Enzymatic defects in testosterone synthesis […] Leydig cell aplasia […] Noonan syndrome […] Chemotherapy or radiation therapy […] Testicular infection (eg, mumps, echovirus, flavivirus) […] Trauma […] High doses of antiandrogen medications (eg, cimetidine, spironolactone, ketoconazole, flutamide, cyproterone) […] […] Secondary (hypothalamic-pituitary) […] Idiopathic hypogonadotropic hypogonadism […] Kallmann syndrome (idiopathic hypogonadotropic hypogonadism with anosmia) […] Prader-Willi syndrome […] Dandy-Walker malformation […] Isolated luteinizing hormone deficiency

• #2 Male Hypogonadism: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/male-hypogonadism.html

  Hypogonadism is an endocrine dysfunction leading to testosterone deficiency. […] Primary hypogonadism is caused by a disorder of testicular testosterone production; the releasing hormones are compensatory increased (hypergonadotropic hypogonadism). […] Secondary hypogonadism is caused by a disturbance of pituitary releasing hormones (hypogonadotropic hypogonadism). […] Hypergonadotropic hypogonadism results from bilateral diseases of the testes, diseases of a solitary testis, or from a disorder of testosterone biosynthesis. […] Congenital diseases: Klinefelter syndrome (47,XXY), disorders of sex development such as 46,XX male syndrome, disorders of testosterone biosynthesis, or anorchidia (vanishing testis syndrome). […] Acquired conditions: Testicular cancer (especially after chemotherapy), testicular torsion, testicular trauma, orchitis, or late-onset hypogonadism.

• #2 Male hypogonadism – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/male-hypogonadism

  Organic causes of primary male hypogonadism include orchitis (e.g., due to gonorrhea, mumps virus infection), bilateral orchiectomy, testicular radiation, chemotherapy, testicular trauma, testicular torsion, hemochromatosis, and older age. Functional causes include medications (e.g., ketoconazole) and varicocele. […] Congenital causes of primary male hypogonadism include Klinefelter syndrome, Down syndrome, cryptorchidism, congenital anorchia (vanishing testes syndrome), Y chromosome microdeletions, LH and FSH receptor genetic variants, and myotonic dystrophy. […] Organic causes of secondary male hypogonadism include damage to the pituitary gland (e.g., due to tumors, infiltrative diseases such as sarcoidosis or hemochromatosis, or infection) and head trauma. Functional causes include critical systemic illness, hyperprolactinemia, medications (e.g., opioids, GnRH agonists, GnRH antagonists, glucocorticoids), cannabis use, anabolic steroid use, obesity, excessive calorie restriction, excessive exercise, and sleep deprivation and other sleep disorders (e.g., OSA).

• #2 Hypogonadism: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001195.htm

  Hypogonadism occurs when the body’s sex glands (gonads) produce little or no hormones. In men, these glands are the testes. In women, these glands are the ovaries. […] The cause of hypogonadism can be primary (testes or ovaries) or secondary (problem with the pituitary or hypothalamus). In primary hypogonadism, the ovaries or testes themselves do not function properly. Causes of primary hypogonadism include: Certain autoimmune disorders, Genetic and developmental disorders, Infection, Iron excess (hemochromatosis), Liver and kidney disease, Radiation (to the gonads), Surgery, Trauma. […] In central hypogonadism, the centers in the brain that control the gonads (hypothalamus and pituitary) do not function properly. Causes of central hypogonadism include: Anorexia nervosa, Bleeding in the area of the pituitary, Taking medicines, such as glucocorticoids and opiates, Stopping anabolic steroids, Genetic problems, Infections, Nutritional deficiencies, Iron excess (hemochromatosis), Radiation (to the pituitary or hypothalamus), Rapid, significant weight loss (including weight loss after bariatric surgery), Surgery (skull base surgery near the pituitary), Trauma, Tumors.

• #2 Male Hypogonadism: Causes, Symptoms, and Treatment

  https://www.verywellhealth.com/male-hypogonadism-8651069

  Acquired causes of primary hypogonadism include: Alcohol overuse: This damages testosterone-producing cells in the testicles, Andropause: A drop in testosterone production due to aging, Chemotherapy: Including alkylating cancer drugs that damage cells in the testicles, Ketoconazole: An antifungal drug that causes a temporary drop in testosterone production, Mumps-related orchitis: Testicular damage caused by mumps, Testicular radiation: Used to treat testicular cancer, Testicular trauma: Including impact or lacerating injuries to both testicles. […] Secondary hypogonadism, also known as central hypogonadism or hypogonadotropic hypogonadism, is caused by an injury to the hypothalamus or pituitary gland or the disruption of the hypothalamus-pituitary-adrenal (HPA) axis (a feedback system that directs when hormones are turned on and off).

• #2 Male hypogonadism: Symptoms and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3255409/

  Too much iron in the blood can cause testicular failure or pituitary gland dysfunction, affecting testosterone production. […] Because of their location outside the abdomen, the testicles are prone to injury. […] Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production. […] Older men generally have lower testosterone levels than younger men do. […] In secondary hypogonadism, the testicles are normal, but function improperly due to a problem with the pituitary or hypothalamus. […] An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. […] Certain inflammatory diseases such as sarcoidosis, Histiocytosis, and tuberculosis involve the hypothalamus and pituitary gland and can affect testosterone production, causing hypogonadism.

• #2 Causes of secondary (hypogonadotropic) hypogonadism in males – UpToDate

  https://www.uptodate.com/contents/causes-of-secondary-hypogonadotropic-hypogonadism-in-males

  Causes of secondary (hypogonadotropic) hypogonadism in males […] Hypogonadism in a male refers to a decrease in either or both of the two major functions of the testes: sperm production and testosterone production. These abnormalities can result from disease of the testes (primary (hypergonadotropic) hypogonadism) or disease of the pituitary or hypothalamus (secondary (hypogonadotropic) hypogonadism). The distinction between these disorders is made by measurement of the serum concentrations of luteinizing hormone (LH) and follicle-stimulating hormone (FSH): […] The patient has secondary (hypogonadotropic) hypogonadism if his serum testosterone concentration and/or the sperm count are low and/or his serum LH and FSH concentrations are not elevated, as they would be if gonadotroph cell function were normal.

• #2 Male hypogonadism | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/male-hypogonadism

  In secondary hypogonadism, the testicles are normal but don’t function properly due to a problem with the pituitary or hypothalamus. A number of conditions can cause secondary hypogonadism, including: Kallmann’s syndrome. This is an abnormal development of the area of the brain that controls the secretion of pituitary hormones (hypothalamus). […] Pituitary disorders. An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. […] Inflammatory disease. Certain inflammatory diseases, such as sarcoidosis, histiocytosis and tuberculosis, involve the hypothalamus and pituitary gland and can affect testosterone production. […] HIV/AIDS. HIV/AIDS can cause low levels of testosterone by affecting the hypothalamus, the pituitary and the testes.

• #2 Hypogonadism: Types, Causes, Symptoms, Treatment, Outlook

  https://www.healthline.com/health/hypogonadism

  Hypogonadism occurs when the sex glands produce little to no sex hormones. […] The causes of primary hypogonadism include: autoimmune diseases such as Addisons disease and hypoparathyroidism, genetic disorders such as Turner syndrome and Klinefelter syndrome, inflammation or mumps involving the testicles or ovaries, undescended testes, liver and kidney diseases, surgery on your sexual organs, radiation exposure. […] Secondary hypogonadism may be the result of the following: genetic disorders such as Kallmann syndrome (abnormal hypothalamic development), injury to your hypothalamus or pituitary gland, a tumor in or near your pituitary gland, pituitary disorders, infections, including HIV, inflammatory diseases such as sarcoidosis and tuberculosis, obesity, rapid weight loss, nutritional deficiencies, use of steroids or opioids, brain surgery, radiation exposure, hemochromatosis, which occurs when your body absorbs too much iron. […] Eugonadotropic hypogonadism may be caused by: delayed menarche, polycystic ovary syndrome (PCOS), hyperprolactinemia, or excess amounts of the hormone prolactin.

• #2 Male Hypogonadism: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/male-hypogonadism.html

  Systemic diseases: Renal insufficiency, hepatic insufficiency, metabolic syndrome, or after chemotherapy. […] Hypogonadotropic hypogonadism results from a deficiency of the pituitary releasing hormones. […] Causes of pituitary insufficiency include tumors, trauma, infarcts (vascular causes, sickle cell disease), infections (bacteria, tuberculosis, sarcoidosis), and hemochromatosis. […] Hyperprolactinemia leads to hypogonadotropic hypogonadism and infertility. […] Isolated LH deficiency is an uncommon disorder. […] Isolated FSH deficiency leads to impaired spermatogenesis with infertility; virilization is normal. […] Hypogonadotropic hypogonadism results from disorders of the hypothalamus with GnRH deficiency. […] Kallmann syndrome presents with anosmia (olfactory dysfunction) and absent GnRH due to a developmental disorder of neurons in the olfactory plate. […] Prader-Willi syndrome is a genetic hypogonadotropic hypogonadism with obesity and retardation.

• #2 Hypogonadism Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/922038-clinical

  Hypogonadism can occur in association with miscellaneous congenital disorders, including Prader-Willi syndrome, Laurence-Moon syndrome, Bardet-Biedl syndrome, and Gaucher disease. Leptin deficiency (also associated with morbid obesity) and iron overload from chronic transfusions or hemochromatosis are other sources of hypogonadism. […] Causes of hypogonadotropic hypogonadism include the following: Central nervous system (CNS) disorders, genetic causes, miscellaneous congenital disorders, and miscellaneous acquired disorders. […] Genetic causes include Kallmann syndrome (mutation in the KAL [anosmin-1] gene, as well as FGFR1, PROK2, and PROKR2), with hyposmia or anosmia or without anosmia. […] Miscellaneous congenital disorders, including Prader-Willi syndrome, Laurence-Moon syndrome, Bardet-Biedl syndrome, and Gaucher disease; leptin deficiency (also associated with morbid obesity) and iron overload from chronic transfusions or hemochromatosis are also associated with hypogonadism. […] Hypergonadotropic hypogonadism in males causes include Klinefelter syndrome, inactivating mutations, and other causes of primary testicular failure. […] Hypergonadotropic hypogonadism in females causes include Turner syndrome, inactivating mutations, and other causes of primary ovarian failure.

• #2 Male hypogonadism – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/male-hypogonadism

  Congenital causes of secondary male hypogonadism include Kallmann syndrome, normosmic congenital hypogonadotropic hypogonadism, CHARGE syndrome, Waardenburg syndrome, congenital adrenal hypoplasia, and septo-optic dysplasia. […] Mixed male hypogonadism results from both disorders of the testes (primary) and the hypothalamus and/or pituitary gland (secondary). Acquired causes include heavy alcohol use, chronic diseases (e.g., HIV, IBD, post-COVID-19 condition, celiac disease), and organ failure (e.g., heart failure, chronic kidney disease, cirrhosis). Congenital causes include congenital adrenal hyperplasia and Prader-Willi syndrome.

• #2 Assessment and management of male androgen disorders: an update

  https://www.racgp.org.au/afp/2014/may/male-androgen-disorders

  Organic congenital causes of secondary hypogonadism are rare and include Kallmann syndrome, GnRH receptor mutation and deficiency, or genetic mutations associated with other pituitary hormone deficiencies. […] Many chronic diseases are associated with low testosterone levels via suppression of gonadotropin production. Testosterone levels are commonly lowered in men with metabolic syndrome, type 2 diabetes mellitus, obesity, depression, obstructive sleep apnoea, chronic kidney disease or anorexia nervosa. […] Hyperprolactinaemia can lead to secondary hypogonadism through suppression of the pulsatile release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. […] In the work-up for secondary hypogonadism, it is very important not to miss pituitary or hypothalamic pathology, which can damage gonadotroph production, resulting in hypogonadism.

• #2 Male hypogonadism | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/male-hypogonadism

  Medications. The use of certain drugs, such as opiate pain medications and some hormones, can affect testosterone production. […] Obesity. Being significantly overweight at any age might be linked to hypogonadism. […] Aging. As men age, there’s a slow, progressive decrease in testosterone production. The rate varies greatly.

• #2 11 Common Causes Of Low Male Testosterone (And How To Fix Them)

  https://www.rupahealth.com/post/an-integrative-medicine-approach-to-low-male-testosterone-hypogonadism

  Both low and high levels of Vitamin D are associated with hypogonadism. A study found that men with very low or very high Vitamin D levels were at increased risk of hypogonadism, suggesting a U-shaped relationship. […] High sugar intake can affect genes responsible for regulating testosterone and estrogen, leading to imbalances. […] Adequate zinc intake is linked to healthy testosterone production and regulation. […] Habits such as smoking and chronic alcohol use can influence testosterone levels. […] Thyroid function, particularly hypothyroidism, is associated with changes in testosterone levels. […] Stress can increase cortisol and may influence testosterone levels. Low testosterone levels have been reported during various stress conditions. […] A study suggests a correlation between gut bacteria and male testosterone levels, indicating that gut health may play a role in hormone balance.

• #2 Male Hypogonadism: Causes, Symptoms, and Treatment

  https://www.verywellhealth.com/male-hypogonadism-8651069

  Congenital causes of secondary hypogonadism include: Gonadotropin-releasing hormone (GnRH) deficiency: A genetic disorder that causes low levels of GnRH hormone, which stimulates testosterone production, Hereditary hemochromatosis: A genetic disorder that causes the accumulation of iron, which can damage the hypothalamus and pituitary gland, Kallmann syndrome: A genetic disorder affecting the hypothalamus that causes delayed or absent puberty in people of any sex. […] Acquired causes of secondary hypogonadism include: Certain medications: Including corticosteroids, opioids, statins, estrogens, and GnRH analogs that directly or indirectly suppress parts of the HPA axis, Chronic diseases: Like human immunodeficiency virus (HIV), coronary artery disease, type 2 diabetes, or chronic kidney disease that disrupt communications in the HPA axis, Excessive exercise: Which increases the production of cortisol, the stress hormone that directly suppresses testosterone production, Inflammatory diseases: Including sarcoidosis, histiocytosis, and tuberculosis that can directly affect the hypothalamus and pituitary gland, Metabolic disorders: Like obesity and metabolic syndrome that increase the production of enzymes called aromatase that transform testosterone into estrogen, Malnutrition: Including severe wasting (cachexia) and eating disorders like anorexia nervosa, Pituitary tumors: Including benign pituitary adenomas or brain tumors that affect the pituitary gland (including benign meningiomas or cancerous gliomas).

• #2 Hypogonadism | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/hypogonadism

  Hypogonadism is a condition that causes decreased function of the gonads, which are the testes in males and the ovaries in females, and decreased production of sex hormones. […] The condition may have genetic, menopausal, autoimmune and viral causes, or may develop after cancer treatments such as radiation and chemotherapy. […] Fasting, weight loss, stress and eating disorders such as anorexia nervosa and bulimia can also cause the condition. […] Pituitary tumors cause some cases of hypogonadism, and treatment involves removing the tumor. […] Hormone replacement therapy has proven to be effective treatment for hypogonadism in men and pre-menopausal women. […] If the condition is caused by a pituitary tumor, treatment will include surgery to remove the tumor.

• #2 Hypogonadism and Health Implications in Men and Women

  https://www.verywellhealth.com/hypogonadism-8784748

  Undescended testicles (cryptorchidism). […] Causes of secondary hypogonadism include: […] Genetic disorders such as Kallmann syndrome, which affects the normal development of the hypothalamus […] Pituitary tumors, such as prolactinomas which secrete excessive amounts of prolactin (a hormone that interferes with the production of estrogen and testosterone) […] Chronic infections like human immunodeficiency virus (HIV), which exposes the hypothalamus and pituitary gland to damaging inflammation […] Inflammatory diseases like sarcoidosis and tuberculosis that directly damage the hypothalamus and pituitary gland […] Traumatic brain injuries (TBIs) that injure the hypothalamus and pituitary gland […] Brain surgery or radiation […] Diabetes, which can affect the hypothalamus and pituitary due to insulin resistance

• #2 Table: Causes of Hypogonadism*-Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/multimedia/table/causes-of-hypogonadism

  Any acute systemic illness […] Hypopituitarism (tumor, infarction, infiltrative disease, infection, trauma, irradiation or pituitary surgery) […] Hyperprolactinemia […] Iron overload (hemochromatosis) […] Certain medications and drugs (eg, estrogens, psychoactive drugs, metoclopramide, opioids, leuprolide, goserelin, triptorelin, some androgen biosynthesis inhibitors for prostate cancer) […] […] Cushing syndrome […] Cirrhosis […] Obesity […] Idiopathic […] Mixed […] Aging […] Alcohol use disorder […] Systemic disease (eg, uremia, liver failure, severe HIV infection, sickle cell disease) […] Medications (eg, corticosteroids)

• #2 What are the Causes of Male Hypogonadism? | NOVA IVF

  https://www.novaivffertility.com/fertility-help/what-are-causes-male-hypogonadism

  Hemochromatosis. Higher than normal levels of iron in the blood can cause pituitary gland dysfunction or testicular failure. […] Treatment for Cancer. Radiation or chemotherapy can interfere with sperm and testosterone production. This may be temporary or permanent. […] Injury to the Testicles. Damage to both testicles may impair testosterone production. […] Mumps Orchitis. If mumps affects the testicles as well as the salivary glands, it can cause long-term testicular damage and impair testosterone production and testicular function. […] This may be caused by: Pituitary disorders: A pituitary tumour, treatment for brain tumours or abnormality in the pituitary gland can impair testosterone production and cause hormonal deficiencies. […] Kallmann syndrome: This refers to the abnormal development of the hypothalamus. […] Inflammatory diseases such as tuberculosis, histiocytosis and sarcoidosis. […] HIV/AIDS. […] Use of certain kinds of pain medication. […] Obesity. […] Weakened immune system resulting from concurrent illnesses. […] Untreated Sleep Apnea.

• #2 Male Hypogonadism – Genitourinary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/genitourinary-disorders/male-reproductive-endocrinology-and-related-disorders/male-hypogonadism

  Primary hypogonadism involves failure of the testes to respond to follicle-stimulating hormone (FSH) and luteinizing hormone (LH). […] The most common genetic cause of primary hypogonadism is Klinefelter syndrome. […] Secondary hypogonadism is failure of the hypothalamus to produce gonadotropin-releasing hormone (GnRH), as in idiopathic hypogonadotropic hypogonadism, or of the pituitary gland to produce enough FSH and LH. […] Any acute systemic illness can cause temporary secondary hypogonadism. […] Some syndromes of hypogonadism have both primary and secondary causes (mixed hypogonadism). […] The table Causes of Hypogonadism lists some common causes of hypogonadism by category. […] Infertility due to primary hypogonadism does not generally respond to hormonal therapy. […] Infertility due to secondary hypogonadism usually responds to gonadotropin replacement therapy. […] Most men who have secondary hypogonadism due to a hypothalamic defect (eg, idiopathic hypogonadotropic hypogonadism, Kallmann syndrome) become fertile with treatment despite sperm counts that are low (eg, 5 million/mL).

• #2 Hypogonadism and Low Testosterone in Men: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Hypogonadism and Low Testosterone in Men: Laboratory Support of Diagnosis and Management Hypogonadism and Low Testosterone in Men

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_Male_Hypgonadism/hypogonadism-and-low-testosterone-in-men-laboratory-support-of-diagnosis-and-management

  Male hypogonadism is a clinical syndrome resulting from decreased testosterone and/or sperm production due to abnormalities of the testis or the hypothalamic-pituitary unit. Prevalence estimates vary depending on the approach used to make the diagnosis. Three types of hypogonadism have been described with organic or functional causes as described below. […] When hypogonadism is diagnosed in men, additional diagnostic evaluation is recommended to determine the cause(s), which are classified as either organic or functional. Organic causes include congenital, structural, or destructive disorders that permanently affect the hypothalamus, pituitary, or testis. The clinical presentation of organic hypogonadism is usually severe, and testosterone supplements are almost always necessary. […] Functional causes of male hypogonadism include comorbidities associated with aging, some medications and drugs of abuse, excessive exercise, organ failure, and renal, endocrine, sleep, and systemic disorders. These causes lead to the suppression of gonadotropins and testosterone, but to a lesser degree than organic causes; suppression by functional causes is potentially reversible upon removal of the cause.

• #2 Acquired Causes of Secondary Hypogonadism in the Adult Male – Hypogonadism

  https://www.medpagetoday.com/resource-centers/hypogonadism/acquired-causes-secondary-hypogonadism-adult-male-/1105

  Type 2 diabetes is also an acquired cause of hypogonadism. In one frequently cited study, at least one-third of men with type 2 diabetes mellitus had low testosterone concentrations associated with inappropriately low LH and FSH concentrations. […] Other states that may lead to an acquired form of hypogonadotropic hypogonadism in the adult male include AIDS, chronic renal failure, cirrhosis, chronic lung disease, critical illness, glucocorticoid therapy, and continuous opioid treatment. Many of these states can lead to suppression of FSH and LH. […] Lastly, infiltrative and infectious disease, along with hemorrhage and trauma involving the pituitary gland, are all possible sources for hypogonadism. Treating the underlying disease, when possible, may have beneficial effects on alleviating the symptoms of hypogonadism.

• #2 Acquired Causes of Secondary Hypogonadism in the Adult Male – Hypogonadism

  https://www.medpagetoday.com/resource-centers/hypogonadism/acquired-causes-secondary-hypogonadism-adult-male-/1105

  Secondary hypogonadism, often called hypogonadotropic hypogonadism, may be due to many common medical conditions and some drugs. Obesity and diabetes are two common conditions linked to secondary hypogonadism. As with other acquired causes of hypogonadism, treatment of the underlying disease may improve symptoms caused by androgen deficiency. […] Two-thirds of Americans are overweight and one-third are obese, so it is important to understand the possible relationship between obesity and secondary hypogonadism. Obesity may be related to suppression of the gonadotropins LH and FSH secreted by the pituitary gland. Additionally, increased conversion of testosterone to estradiol by aromatase is common in adipocytes, leading to greater feminizing and decreased androgenic features as obesity becomes more severe.

• #2 Male Hypogonadism: A Review of the Disease and Its Treatment

  https://www.uspharmacist.com/article/male-hypogonadism-a-review-of-the-disease-and-its-treatment

  Male hypogonadism is defined as a testicular dysfunction resulting in decreased sperm and testosterone production. This disorder is not uncommon and frequently goes undiagnosed due to the nonspecific clinical presentation of the disease. However, male hypogonadism has been described in up to 20% of men over the age of 70 years and has been reported in 4% of all men. Trends demonstrating higher frequency of males affected by this disorder may be related to increased life expectancy, as rates of hypogonadism increase with age. In addition, the growing numbers of Americans who are overweight and who develop type 2 diabetes mellitus have also been described as potential causes for the increasing prevalence. Recent data have suggested that up to one-third of men with a diagnosis of type 2 diabetes and a body mass index (BMI) of 30 kg/m2 have hypogonadism defined by a low serum-free testosterone level. The cause for reduced androgen levels in these patients is unclear; however, there have been some proposed mechanisms for this observation.

• #2 ReThink Testosterone: 5 Main Causes of Low T in a Nutshell

  https://www.rethinktestosterone.com/blog/triggers-of-male-hypogonadism

  The American Diabetes Association notes that men with diabetes are twice as likely to develop low testosterone a significant difference when compared to healthy individuals. […] A meta-analysis found a connection between low testosterone levels and type II diabetes, as low testosterone levels are linked to insulin resistance. […] One of the main causes of low T is not an underlying medical problem but a side effect of certain medications. […] The issue with anabolic steroids is that unprescribed use is common, leading to an array of side effects and medical complications after cessation. […] Another primary cause of low T is the excessive consumption of alcohol as it can affect multiple facets of the male reproductive system. […] Liver cirrhosis, which can originate from long-term alcohol abuse, has also been linked to low testosterone levels.

• #2 What Is Hypogonadism? Symptoms, Diagnosis, Treatment

  https://www.everydayhealth.com/sexual-health/hypogonadism/guide/

  Disorders that cause primary male hypogonadism include Klinefelter syndrome, the result of an extra X chromosome. […] Other causes of primary hypogonadism include complications from the mumps and physical injury to the testicles or ovaries. […] Obesity is a risk factor for male hypogonadism. Body fat contains an enzyme called aromatase that converts testosterone into estrogen, causing hormonal imbalance. […] Type 2 diabetes is a risk factor for hypogonadism. Chubak says, Diabetes can do a number on a lot of different organs, including causing fibrosis, a type of scarring. So one potential explanation [for hypogonadism] is that the sexual organs have a little bit of fibrosis due to diabetes. […] An estimated 35 percent of men older than 45 and an estimated 30 to 50 percent of men with obesity or type 2 diabetes have hypogonadism, according to the Endocrine Society.

• #2 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  There is a high prevalence of LOH within specific populations, including patients with obesity, type 2 diabetes (T2DM), metabolic syndrome (MetS), cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), renal disease and cancer. In particular low testosterone levels are relatively common in men with T2DM and in those with metabolic derangements. […] Klinefelter syndrome, a trisomy associated with a 47,XXY karyotype, is the most prevalent genetic cause of primary hypogonadism, with a global prevalence of 1/500-1,000 live male births. However, 50% of individuals with Klinefelter syndrome are diagnosed during their lifetime. […] Male hypogonadism can be classified according to the aetiology into primary hypogonadism or secondary hypogonadism. A compensated or subclinical form of hypogonadism, characterised by normal testosterone serum levels and elevated luteinising hormone (LH) production, has also been reported; the clinical significance of this condition is unclear.

• #2 The 'male menopause’

  https://www.nhs.uk/conditions/male-menopause/

  Some men develop depression, loss of sex drive, erectile dysfunction, and other physical and emotional symptoms when they reach their late 40s to early 50s. […] A testosterone deficiency that develops later in life, also known as late-onset hypogonadism, can sometimes be responsible for these symptoms, but in many cases the symptoms are nothing to do with hormones. […] In some cases, where lifestyle or psychological problems do not seem to be responsible, the symptoms of the „male menopause” may be the result of hypogonadism, where the testes produce few or no hormones. […] Hypogonadism can also occasionally develop later in life, particularly in men who are obese or have type 2 diabetes. […] This is known as late-onset hypogonadism and can cause the „male menopause” symptoms. […] A diagnosis of late-onset hypogonadism can usually be made based on your symptoms and the results of blood tests used to measure your testosterone levels.

• #2 Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/

  Hypogonadism is defined as deficient or absent male gonadal function that results in insufficient testosterone secretion. Hypogonadism may be primary due to testicular failure, or secondary due to hypothalamic-pituitary axis dysfunction, resulting in the production or release of insufficient testosterone to maintain testosterone-dependent functions and systems. Hypogonadism can also result from a combination of testicular failure and hypothalamic-pituitary axis dysfunction. […] If a repeat assay confirms low testosterone, luteinizing hormone (LH) should be measured to determine whether the cause is primary or secondary. LH levels 2 ng/mL suggest a hypothalamic lesion (pituitary adenoma, trauma, etc), whereas LH levels 10 ng/mL indicate primary testicular failure. Levels within the normal range suggest an age-related, decreased hypothalamic response to declining testosterone levels.

• #2 Assessment and management of male androgen disorders: an update

  https://www.racgp.org.au/afp/2014/may/male-androgen-disorders

  The practitioner needs to be aware that men with prior or current anabolic steroid use may present with low testosterone and LH levels and use may be denied even with specific questioning. […] It is very important to remember that an underlying aetiology should always be sought before testosterone therapy is considered. […] Testosterone replacement is recommended for symptomatic classical androgen deficiency syndromes after excluding contraindications in the initial work up. […] Older obese men with chronic comorbidities commonly present with non-specific symptoms and modestly low testosterone. […] The risk-benefit ratio of testosterone therapy in such men is less favourable than in men with organic androgen deficiency. […] Large, well-conducted clinical trials are needed to provide more evidence to guide clinicians and patients regarding the benefits, and risks, of testosterone therapy.

• #3 Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/

  Hypogonadism is defined as deficient or absent male gonadal function that results in insufficient testosterone secretion. Hypogonadism may be primary due to testicular failure, or secondary due to hypothalamic-pituitary axis dysfunction, resulting in the production or release of insufficient testosterone to maintain testosterone-dependent functions and systems. Hypogonadism can also result from a combination of testicular failure and hypothalamic-pituitary axis dysfunction. […] If a repeat assay confirms low testosterone, luteinizing hormone (LH) should be measured to determine whether the cause is primary or secondary. LH levels 2 ng/mL suggest a hypothalamic lesion (pituitary adenoma, trauma, etc), whereas LH levels 10 ng/mL indicate primary testicular failure. Levels within the normal range suggest an age-related, decreased hypothalamic response to declining testosterone levels.

• #3 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  There is a high prevalence of LOH within specific populations, including patients with obesity, type 2 diabetes (T2DM), metabolic syndrome (MetS), cardiovascular diseases (CVD), chronic obstructive pulmonary disease (COPD), renal disease and cancer. In particular low testosterone levels are relatively common in men with T2DM and in those with metabolic derangements. […] Klinefelter syndrome, a trisomy associated with a 47,XXY karyotype, is the most prevalent genetic cause of primary hypogonadism, with a global prevalence of 1/500-1,000 live male births. However, 50% of individuals with Klinefelter syndrome are diagnosed during their lifetime. […] Male hypogonadism can be classified according to the aetiology into primary hypogonadism or secondary hypogonadism. A compensated or subclinical form of hypogonadism, characterised by normal testosterone serum levels and elevated luteinising hormone (LH) production, has also been reported; the clinical significance of this condition is unclear.

• #3 Male hypogonadism: Symptoms and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3255409/

  Male hypogonadism is characterized by a deficiency in testosterone a critical hormone for sexual, cognitive, and body function and development. […] Low testosterone levels may be due to testicular, hypothalamic, or pituitary abnormalities. […] Either type of hypogonadism may be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as an injury or an infection. […] Common causes of primary hypogonadism include: Klinefelter’s Syndrome: This condition results from a congenital abnormality of the sex chromosomes, X and Y. […] The extra X chromosome that occurs in Klinefelter’s syndrome causes abnormal development of the testicles, which in turn results in the underproduction of testosterone. […] If a mumps infection involving the testicles in addition to the salivary glands (mumps orchitis) occurs during adolescence or adulthood, long-term testicular damage may occur.

• #3 Male hypogonadism: Symptoms and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3255409/

  Too much iron in the blood can cause testicular failure or pituitary gland dysfunction, affecting testosterone production. […] Because of their location outside the abdomen, the testicles are prone to injury. […] Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production. […] Older men generally have lower testosterone levels than younger men do. […] In secondary hypogonadism, the testicles are normal, but function improperly due to a problem with the pituitary or hypothalamus. […] An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. […] Certain inflammatory diseases such as sarcoidosis, Histiocytosis, and tuberculosis involve the hypothalamus and pituitary gland and can affect testosterone production, causing hypogonadism.

• #3 Testosterone Deficiency / Low (Hypogonadism): Causes, Symptoms, Diagnosis and Treatment

  https://dreminozbek.com/en/testosterone-deficiency-low-hypogonadism-causes-symptoms-diagnosis-and-treatment/

  The primary causes of low testosterone in men, that is, due to a disorder in the testicles, are as follows; […] Klinefelter syndrome: This condition is caused by a defect in the X and Y chromosomes. A normal male has one X and one Y chromosome. These patients have one Y chromosome and two or more X chromosomes. […] Undescended testis (cryptorchidism): the testis should normally be located in the scrotum. In some children, the testicles may be in the groin or in the abdomen, not where they should be normally. In this case, because the testicles cannot develop sufficiently, there is an insufficiency in T production. […] Mumps orchitis: Mumps virus can sometimes also infect the testicles. This condition is called orchitis. In mumps orchitis in adult or adolescence, testicular damage may develop and sperm production is impaired. […] Bacterial orchitis: Testicular inflammation caused by different microorganisms may cause testosterone deficiency. […] Testicular trauma: As a result of trauma to the testicles for various reasons, testicular damage and low testosterone may occur depending on the degree of trauma. If a testicle is normal, its usually okay. […] Radiotherapy and chemotherapy: In patients undergoing chemotherapy (drug therapy) or radiotherapy (radiation therapy) for cancer, the testicles may have problems in the production of sperm and testosterone. […] Hemochromatosis: This disease is a metabolic disease. As a result of excessive iron accumulation in the testicles and pituitary gland, disruptions in the hormone production of the organs occur. If only one testicle is involved and the other is normal, testosterone production is usually normal.

• #3 Male Hypogonadism: A Review of the Disease and Its Treatment

  https://www.uspharmacist.com/article/male-hypogonadism-a-review-of-the-disease-and-its-treatment

  Acquired primary hypogonadism occurs when a patient is exposed to a substance, experiences trauma, or contracts a disease or infection that results in decreased sperm and testosterone production, often leading to infertility. Common medication causes resulting in this disorder include glucocorticoids, ketoconazole, and alkylating/neoplastic agents (e.g., cyclophosphamide, chlorambucil, cisplatin, and busulfan). […] Secondary hypogonadism is labeled hypogonadotropic hypogonadism. This occurs with dysfunction of pituitary gonadotropin release or hypothalamic release of GnRH. As a result, testosterone and sperm counts are proportionately low while serum LH and follicle-stimulating hormone (FSH) are normal, identifying a problem with the stimulating pathway in androgen synthesis. Additionally, this disorder is characterized as either congenital or acquired. Acquired secondary hypogonadism is caused by any disease or substance that can alter the hypothalamic-pituitary-adrenal (HPA) axis. Medications that can increase the risk of developing this disorder include gonadal steroids, GnRH analogues, glucocorticoids, and chronic opiates. […] Causes of both congenital and acquired primary hypogonadism are listed in TABLE 1. […] Additional causes of the secondary forms of hypogonadism are listed in TABLE 2.

• #3 Male hypogonadism | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/

  Male hypogonadism is the result of deficiency of the male sex hormone testosterone. […] Male hypogonadism can be divided into two groups. Classical hypogonadism is where the low levels of testosterone are caused by an underlying specific medical condition, for example Klinefelter’s syndrome, Kallmanns syndrome or a pituitary tumour. Late-onset hypogonadism is where the decline in testosterone levels is linked to general ageing and/or age-related diseases. Additionally, obesity and type 2 diabetes can be associated with hypogonadism in men. […] There are two types of classical male hypogonadism primary and secondary. Primary hypogonadism occurs when the low level of testosterone is due to conditions affecting the testes. […] Secondary hypogonadism occurs when signalling to the testis is unable to stimulate sufficient testosterone production and is caused by conditions affecting the function of the hypothalamus and/or pituitary gland.

• #3 Hypogonadism: Types, Causes, Symptoms, Treatment, Outlook

  https://www.healthline.com/health/hypogonadism

  Hypogonadism occurs when the sex glands produce little to no sex hormones. […] The causes of primary hypogonadism include: autoimmune diseases such as Addisons disease and hypoparathyroidism, genetic disorders such as Turner syndrome and Klinefelter syndrome, inflammation or mumps involving the testicles or ovaries, undescended testes, liver and kidney diseases, surgery on your sexual organs, radiation exposure. […] Secondary hypogonadism may be the result of the following: genetic disorders such as Kallmann syndrome (abnormal hypothalamic development), injury to your hypothalamus or pituitary gland, a tumor in or near your pituitary gland, pituitary disorders, infections, including HIV, inflammatory diseases such as sarcoidosis and tuberculosis, obesity, rapid weight loss, nutritional deficiencies, use of steroids or opioids, brain surgery, radiation exposure, hemochromatosis, which occurs when your body absorbs too much iron. […] Eugonadotropic hypogonadism may be caused by: delayed menarche, polycystic ovary syndrome (PCOS), hyperprolactinemia, or excess amounts of the hormone prolactin.

• #3 Hypogonadism: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/922038-overview

  Hypogonadotropic hypogonadism can result from the following: Central nervous system (CNS) disorders – Including tumors and miscellaneous causes involving the pituitary/hypothalamic area […] Genetic causes – Eg, Kallmann syndrome […] Congenital disorders – Eg, Prader-Willi syndrome, Laurence-Moon syndrome, Bardet-Biedl syndrome, and Gaucher disease […] Acquired disorders – Eg, exercise-induced hypogonadism, psychogenic hypogonadism, hyperprolactinemia, Cushing syndrome, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), morbid obesity, type II diabetes mellitus. […] Causes of hypergonadotropic hypogonadism (primary hypogonadism) in males include the following: Klinefelter syndrome […] Inactivating mutation […] Chemotherapy […] Radiation therapy […] Gonadectomy […] Anorchism and cryptorchidism […] Testicular biosynthetic defects – 17-hydroxylase dehydrogenase deficiency, 5-reductase deficiency, 17-hydroxylase deficiency […] Defects in testicular determination – Gonadal dysgenesis […] Other rare disorders of sex development (DSDs) – Ovotesticular DSD, XX males […] Sertoli-cell-only syndrome […] LH resistance.

• #3 Male hypogonadism – when two endocrine causes merge in the same patient | ECE2018 | 20th European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0056/ea0056p810

  Male hypogonadism is defined by lower levels of testosterone than expected for age-matched individuals. […] In primary or hypergonadotropic hypogonadism, LH and FSH show a compensatory elevation to low testosterone levels, while in the secondary or hypogonadotropic hypogonadism the low testosterone levels are a result of insufficient gonadotropin levels. […] Hyperprolactinemia is a cause of hypogonadotropic hypogonadism. […] Klinefelter syndrome is a common sex-chromosome aneuploidy with clinical features that include the development of hypergonadotropic hypogonadism. […] The underlying hypergonadotropic hypogonadism was initially masked as a result of gonadotropin suppression by high levels of prolactin. […] The diagnosis of Klinefelter syndrome is important to alert the clinician to other common comorbidities.

• #3 Male hypogonadism: Symptoms and treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3255409/

  The use of certain drugs, such as, opiate pain medications and some hormones, can affect testosterone production. […] Being significantly overweight at any age may be linked to hypogonadism. […] Stress, excessive physical activity, and weight loss have all been associated with hypogonadism. […] Recent studies have found that testosterone production slowly decreases as a result of aging, although the rate of decline varies. […] The proposed causes for the effects of obesity on testosterone level include increased clearance or aromatization of testosterone in the adipose tissue and increased formation of inflammatory cytokines, which hinder the secretion of the gonadotropin-releasing hormone. […] Although diabetes mellitus-related hypogonadism was previously thought to be associated with testicular failure, study results show one-third of diabetic men had low testosterone levels, but also had low pituitary hormone levels. […] Certain medications are shown to reduce testosterone production.

• #3 Male Hypogonadism – Houston, TX: The Endocrine Center

  https://www.endocrinecenter.com/contents/educational-information/male-hypogonadism-1

  Pituitary disorders. An abnormality in the pituitary gland can impair the release of hormones from the pituitary gland to the testicles, affecting normal testosterone production. […] Inflammatory disease. Certain inflammatory diseases, such as sarcoidosis, histiocytosis and tuberculosis, involve the hypothalamus and pituitary gland and can affect testosterone production, causing hypogonadism. […] HIV/AIDS. HIV/AIDS can cause low levels of testosterone by affecting the hypothalamus, the pituitary and the testes. […] The use of certain drugs, such as opiate pain medications and some hormones, can affect testosterone production. […] Normal aging. Older men generally have lower testosterone levels than younger men do. […] The reproductive system can temporarily shut down due to the physical stress of an illness or surgery, as well as during significant emotional stress.

• #3 Male Hypogonadism: Symptoms, Causes & Treatment | hims

  https://www.forhims.co.uk/conditions/male-hypogonadism

  Some of the causes of male hypogonadism are genetic, meaning they’re inherited from your parents or caused by genetic abnormalities that occurred spontaneously when you were conceived. Other causes are acquired, meaning you develop them throughout your life. […] Causes of primary hypogonadism include: Klinefelter syndrome, undescended testicles, mumps orchitis, cancer treatment, aging, and hemochromatosis. […] Causes of secondary hypogonadism include: congenital abnormalities, Kallmann syndrome, stress-related hypogonadotropic hypogonadism, pituitary tumors, Sheehan syndrome, infections, anabolic steroids, and traumatic head injury.

• #3 Hypogonadism and Health Implications in Men and Women

  https://www.verywellhealth.com/hypogonadism-8784748

  Pituitary disorders, including Cushing’s syndrome and diabetes insipidus […] Obstructive sleep apnea, in which decreased blood oxygen from breathing gaps impairs hypothalamus function […] Nutritional deficiencies, such as vitamin C, D, B1, and B12, which aid in nerve signaling and the normal function of the hypothalamus […] Eating disorders like anorexia nervosa that cause malnutrition […] Obesity, in which fatty tissues release excessive amounts of the enzyme aromatase that converts testosterone into estrogen […] Medications like opioids and anabolic steroids that disrupt communications between the hypothalamus and pituitary gland […] Hemochromatosis (iron overload) which overwhelms the hypothalamus and pituitary gland with iron deposits. […] Primary hypogonadism occurs when the testes or ovaries do not function properly, and secondary hypogonadism occurs when the hypothalamus or pituitary gland does not work properly.

• #3 Male Hypogonadism: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/male-hypogonadism.html

  Systemic diseases: Renal insufficiency, hepatic insufficiency, metabolic syndrome, or after chemotherapy. […] Hypogonadotropic hypogonadism results from a deficiency of the pituitary releasing hormones. […] Causes of pituitary insufficiency include tumors, trauma, infarcts (vascular causes, sickle cell disease), infections (bacteria, tuberculosis, sarcoidosis), and hemochromatosis. […] Hyperprolactinemia leads to hypogonadotropic hypogonadism and infertility. […] Isolated LH deficiency is an uncommon disorder. […] Isolated FSH deficiency leads to impaired spermatogenesis with infertility; virilization is normal. […] Hypogonadotropic hypogonadism results from disorders of the hypothalamus with GnRH deficiency. […] Kallmann syndrome presents with anosmia (olfactory dysfunction) and absent GnRH due to a developmental disorder of neurons in the olfactory plate. […] Prader-Willi syndrome is a genetic hypogonadotropic hypogonadism with obesity and retardation.

• #3 Testosterone Deficiency / Low (Hypogonadism): Causes, Symptoms, Diagnosis and Treatment

  https://dreminozbek.com/en/testosterone-deficiency-low-hypogonadism-causes-symptoms-diagnosis-and-treatment/

  In secondary hypogonadism, the testicles are normal, but there is a problem in the central nervous system (pituitary and hypothalamus) and therefore not enough T hormone can be produced from the testicles. Common causes of secondary hypogonadism are; […] Kallman syndrome: There is a problem in the central nervous system here. Because of this disorder, enough testicular stimulating hormone cannot be secreted from the hypothalamus. Kalmam syndrome may also have vision problems such as olfactory and red-green color blindness. […] Pituitary gland diseases: Pituitary gland tumors in the central nervous system, tumors adjacent to the pituitary gland, the pituitary gland is adversely affected due to previous surgery or radiation. As a result of these, the hormone stimulating the testicles cannot be secreted sufficiently from the pituitary and as a result, low T occurs. […] Chronic inflammatory diseases: Hypogonadism can be seen as a result of diseases affecting the pituitary and hypothalamus such as sarcoidosis, histiocytosis X, tuberculosis. […] HIV/AIDS: These diseases are sexually transmitted diseases. They cause T deficiency by affecting the hypothalamus and pituitary. […] Drug habits: Some hormones, addictive drugs negatively affect T production. […] Diabetes (Diabetes): If diabetes is prolonged and uncontrolled, it reduces T production. […] Excess weight (obesity): Excess weight can reduce T production. […] Advanced age: As a result of aging, T hormone production decreases. […] Genetic diseases: Some genetic diseases affect T production negatively. […] Excessive smoking and alcohol use: Excessive alcohol and smoking affect the hormonal balance negatively. […] Liver and kidney diseases: Cirrhosis and kidney failure impair hormone production. […] Excessive stress: A stressful work environment and social life negatively affect T levels.

• #3 Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management

  https://www.mdpi.com/2075-4418/13/24/3650

  Testosterone (T), the principal androgen secreted by the testes, plays an essential role in male health. Male hypogonadism is diagnosed based on a combination of associated clinical signs and symptoms and laboratory confirmation of low circulating T levels. […] Causes of primary hypogonadism include Klinefelter’s syndrome, undescended testes, mumps orchitis, haemochromatosis, cancer chemotherapy, and normal ageing. Causes of secondary hypogonadism include Kallman syndrome, pituitary disorders (including pituitary adenoma), head injury, human immunodeficiency virus (HIV), obesity, alcohol misuse, corticosteroid treatment, liver failure, uraemia, and stress-related hypogonadism. […] Primary hypogonadism is caused by testicular failure and is characterised by low serum T and high luteinizing hormone (LH) and follicle-stimulating hormone (FSH) concentrations in the blood. For this reason, primary hypogonadism is also known as hypergonadotropic hypogonadism. In secondary hypogonadism (hypogonadotropic hypogonadism), defects in the hypothalamus or pituitary result in low T levels because of insufficient stimulation of the Leydig cells in the testes. […] Low T concentrations can be caused by a combination of both primary and secondary hypogonadism (also called mixed hypogonadism) that reflects defects in the hypothalamus and/or the pituitary as well as the testes.

• #3 EAU Guidelines on Sexual and Reproductive Health – Uroweb

  https://uroweb.org/guidelines/sexual-and-reproductive-health/chapter/male-hypogonadism

  The classification of hypogonadism has also been divided into two broad categories: Classical/Organic and Functional, often but not correctly identified as LOH. The clinical effects of testosterone deficiency are however common to all patients independent of the cause of the hypogonadism; although, they may vary in severity or as a result of age of onset. […] Finally, hypogonadism can also result from several conditions leading to reduced sensitivity/insensitivity to testosterone and its metabolites. […] The current guidelines maintain a classification of Primary and Secondary Hypogonadism, with special reference to LOH. The classification, based on the aetiology of hypogonadism, allows clinicians to adequately select appropriate treatment. In patients with secondary hypogonadism, both fertility and testosterone normalisation can be theoretically achieved with adequate treatment, whereas in primary hypogonadism only testosterone therapy can be considered, which eventually impairs fertility due to suppression of the HPT axis.

• #3 Male hypogonadism | Endocrine Conditions

  https://www.yourhormones.info/endocrine-conditions/male-hypogonadism/

  Male hypogonadism does not run in families. There are genetic causes of hypogonadism, which include Klinefelters syndrome and Kallmanns syndrome; however, these conditions occur sporadically, they are not inherited from the parents. […] Male hypogonadism has been linked with an increased risk of developing heart disease (low testosterone can cause an increase in cholesterol levels). Studies have shown that testosterone levels can be lower in men with type 2 diabetes and in men with excess body weight. However, it is not clear whether this is an association or a direct cause and effect.

• #3 What Is Hypogonadism? Symptoms, Diagnosis, Treatment

  https://www.everydayhealth.com/sexual-health/hypogonadism/guide/

  Disorders that cause primary male hypogonadism include Klinefelter syndrome, the result of an extra X chromosome. […] Other causes of primary hypogonadism include complications from the mumps and physical injury to the testicles or ovaries. […] Obesity is a risk factor for male hypogonadism. Body fat contains an enzyme called aromatase that converts testosterone into estrogen, causing hormonal imbalance. […] Type 2 diabetes is a risk factor for hypogonadism. Chubak says, Diabetes can do a number on a lot of different organs, including causing fibrosis, a type of scarring. So one potential explanation [for hypogonadism] is that the sexual organs have a little bit of fibrosis due to diabetes. […] An estimated 35 percent of men older than 45 and an estimated 30 to 50 percent of men with obesity or type 2 diabetes have hypogonadism, according to the Endocrine Society.

• #3 What Causes Low Testosterone in Men? – Nava Health

  https://navacenter.com/what-causes-low-testosterone-levels-in-men/

  Diabetes: According to WebMD, as many as half of individuals with diabetes have low testosterone. However, medical professionals aren’t yet sure whether diabetes causes low testosterone, or whether low testosterone causes diabetes. […] High estrogen levels: Both men and women naturally have testosterone and estrogen. However, excessive estrogen levels can contribute to low testosterone. […] Injury to the testes: The testes, which produce testosterone in men, are relatively unprotected in comparison to other vital organs. […] Testicular infection: Low testosterone can be caused by an infection of the testes, including testicular cancer and epididymitis, which involves inflammation of the epididymis. […] Adverse effects of medications: Many medications, including opioids, steroids, and various cancer treatments, can lead to lower testosterone levels. […] Chronic kidney failure: Men with kidney disease are more likely to have low testosterone levels. […] HIV/AIDS: AIDS can lead to lower testosterone levels, as the disease can affect the pituitary gland, hypothalamus, and testes, all of which are essential to proper hormone regulation.

• #3 What Causes Low Testosterone? – Oviedo Medical Research

  https://oviedomedicalresearch.com/what-causes-low-testosterone/

  Men naturally decrease testosterone production as they age. Typically, there is a testosterone drop of 1-2% for each birthday you experience. This is normal. However, a condition known as hypogonadism can happen at any age where the testicles dont produce enough testosterone. […] There are two types of hypogonadism: primary and secondary. […] In primary hypogonadism, the testes fail to make enough testosterone due to an inherited physical condition or due to damage to the testicles. For example, undescended testicles or a condition called Klinefelters syndrome are inherited genetic issues that affect testosterone production. Cancer treatment, such as radiation, can affect testosterone production as can a mumps infection. […] Secondary hypogonadism damages the pituitary gland or hypothalamus, two glands that control hormone production. Medications and obesity can fall into this category, along with inflammatory diseases like tuberculosis or even HIV/AIDS, all of which can disrupt the production of testosterone and cause secondary hypogonadism.

• #3 Prevalence, Diagnosis and Treatment of Hypogonadism in Primary Care Practice » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/publications/prevalence-diagnosis-and-treatment-of-hypogonadism-in-primary-care-practice/

  Several treatment options exist for testosterone replacement, including oral preparations of testosterone derivatives; intramuscular injections of long-acting testosterone esters; transdermal patches applied to the scrotum or other areas of the body (eg, upper arms, legs, abdomen, or back); and a recently approved 1% testosterone gel. […] Testosterone replacement therapy can return hormone levels to normal ranges and help alleviate the symptoms associated with hypogonadism.

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