Male hypogonadism: know the symptoms and treatments


What is Male Hypogonadism?

Hypogonadism is a disease in which the testicles produce little or no sex hormones and cannot be cured. When there is this problem, the absence of puberty and infertility are common. There may still be a lack of development of the sexual organ due to the disease.

With hypogonadism, men suffer from testosterone. In addition to this hormone, they may not produce sperm.

Types of Male Hypogonadism and Causes

Hypogonadism can be separated into primary and secondary, or else, hypergonadotropic hypogonadism and hypogonadotropic hypogonadism, respectively.

Check below the characteristics and causes of each one:

Primary Hypogonadism or Hypergonadotrophic Hypogonadism

Primary hypogonadism is characterized by the fact that the testicles do not function properly, producing little or no sex hormone.

Its causes are:

  • Infections;
  • Surgeries;
  • Autoimmune diseases;
  • Genetic problems, such as Klinefelter’s Syndrome;
  • Radiation;
  • Liver diseases;
  • Kidney diseases.

Secondary Hypogonadism or Hypogonadotrophic Hypogonadism

In secondary hypogonadism, the pituitary and hypothalamus are the sites in the brain that control the gonads (testicles and ovaries) that do not function properly, preventing the production of sex hormones.

The causes of secondary hypogonadism are known to:

  • Infections;
  • Genetic problems;
  • Abnormal bleeding;
  • Radiation;
  • Tumors;
  • Nutritional deficiencies;
  • Excess iron;
  • Rapid weight loss;
  • Surgery.

Risk factors

Patients who have a history of diseases mentioned in the causes, such as, for example, autoimmune , liver and kidney diseases, infections, genetic problems and others, may need a personalized and specialized evaluation.

Patients over the age of 60 are also more likely to have the disease because of decreased sex hormone production. It is necessary to carry out blood tests with a certain frequency to identify possible health problems.


The classification of hypogonadism can be separated by the ways in which the disease can be found.

Testicular insufficiency alobal

Klinefelter’s syndrome is frequent and causes infertility. Symptoms are: azoospermia, mild mental retardation with hyalinization of seminiferous tubules and gynecomastia (growth of male breasts).

UllrichNoonan syndrome

This syndrome is related to micropenis, cryptoquidia and short stature.


It is the absence of male gonads with symptoms of hypogonadism in adulthood. The differential prepuberal diagnosis must be made with bilateral cryptorchidism until the etiology is known, the disease can be called male pseudohermaphrodite.

Myotonic dystrophy

It is a muscle disease associated with conditions ranging from infertility to decreased testosterone.

Seminiferous insufficiency

Orchids (caused by the mumps virus are the most common), radiation, germ aplasia, autoimmunity and drugs.

Androgenic insufficiency

Caused by androgen receptor defect, defects in testosterone synthesis, defects in the conversion of testosterone to DHT and male climacteric.

Hypogonadotrophic hypogonadism

Male hypogonadism due to gonadotrophic deficiency may be different from hypergonadotrophic in that it secondarily affects the testicle derived from hypothalamic or pituitary pathology, with low levels of gonadotropins.


Is characterized by:

  • Ischemia;
  • Production of anomalous gonadotropins;
  • Hemocromatose;
  • Infiltrative diseases (sarcoidosis, histiocytosis, tuberculosis);
  • Expansive intrasellar processes (prolactinomas, gonadotropin-producing adenomas).


Hypothalamic hypogonadism is characterized by the following items:

  • Associated with other deficiencies of releasing factors (infiltrative diseases, radiation and tumors)
  • Genetic syndromes (LaurendeMoonBiedl, PraderWilli)
  • Isolated GnRH deficiency (with anosmia Kallmann syndrome, without anosmia and its variants.

Symptoms of Male Hypogonadism

Before puberty, the symptoms are usually:

  • There is no development of the penis until the age of 16;
  • There is no change in the voice until the age of 16;
  • There is no development of pubic hair;

After puberty, male symptoms are usually:

  • Decreased body hair and beard;
  • Small male sex organ;
  • Loss of muscle mass;
  • Decreased libido;
  • Hip development (similar to the female);
  • Fine voice;
  • Sexual impotence;
  • Reduction of sperm production;
  • Discouragement and lack of energy;
  • Breast growth (gynecomastia);
  • Abnormal growth of arms and legs;


The diagnosis can be made by urologists, radiologists, pediatricians, general practitioners or endocrinologists. These are the doctors best suited to assist in the treatment of hypogonadism.

The diagnosis is made through a conversation, in which the doctor discovers the patient’s clinical history, as well as tests, which can be performed to confirm what the doctor already suspected.

The tests that may be required by the doctor are:

  • Panel of hormones such as: estradiol, progesterone, testosterone, FSH, LH, DHT, TSH, T4L and prolactin;
  • Ultrasound of the testicles;
  • Spermogram;
  • Pituitary resonance.

What is the treatment for Male Hypogonadism?

Treatment varies depending on the cause of the disease. When hypogonadism is caused by a tumor, surgery or the use of medications can be effective treatments.

In cases of traumatic injury or not in the testicle, due to autoimmune diseases, treatment is done with the replacement of sexual hormones that are missing.

Medicines used to treat the disease

The most suitable drugs to treat hypogonadism are known as:

  • Durateston ;
  • Deposteron ;
  • Nebido;
  • Choriomon M.

This treatment is done with hormonal therapy and the only person who can prescribe the medication is the doctor. Do not self-medicate or interrupt treatment without his indication.


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.


The main complication of hypogonadism is infertility, if the person wants to have children. As there is a lack of hormones, it can also occur:

  • Metabolic alterations (strokes and heart attacks);
  • Change in mood;
  • Weight gain;
  • Loss of muscle mass;
  • Change in sexual development.

How to live with the problem

To live with the problem, it is recommended to do the treatment correctly. This happening, the patient can have a normal life.

Depending on the cause of the problem, some changes may be made by the doctor.


As the causes are varied, only a few can be prevented as is the case with diabetes . Sleep well, eat properly and practice physical activities are indicated to prevent hypogonadism.

Consulting the doctor is always the best way to have a correct diagnosis of your problem, whatever it may be. Not self-medicating is essential to avoid health problems caused by side effects.

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