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Male hypogonadism - inability to produce testosterone or sperm

The inability of the male testicles to produce testosterone or sperm is known as male hypogonadism. The condition also is known as testosterone deficiency. It occurs only in men.

Testicles are genital organs that are part of the male reproductive system. These two oval-shaped organs are located in a pouch of skin called the scrotum. It hangs below the abdomen and behind the penis. Along with producing the sperm cells that are necessary for reproduction, the testicles are responsible for secretion of the male hormone, testosterone. The hormone testosterone is necessary for the development and maintenance of masculine physical characteristics.

During fetal development, testosterone is necessary for the formation of male genital organs. During puberty, testosterone is essential for the development of secondary sexual characteristics, such as facial hair, greater muscle mass and a deeper voice. In adulthood, testosterone maintains muscle mass and strength, fat distribution, bone mass, sperm production, sex drive and potency.

Symptoms of male Hypogonadism

The symptoms vary according to the stage in which the patient suffers from this disorder. If this problem occurs during fetal development it may lead to ambiguous genitalia, that is the sex of the child is not clearly determined at birth.

Symptoms of male hypogonadism during puberty include:

• Decreased development of muscle mass
• Lack of deepening of the voice
• Impaired growth of body hair
• Impaired growth of the penis and testicles
• Excessive growth of the arms and legs in relation to the trunk of the body
• Development of breast tissue

Symptoms during adulthood can be:

• Erectile dysfunction
• Infertility
• Decrease in beard and body hair growth
• Increase in body fat
• Decrease in size or firmness of testicles
• Development of breast tissue
• Osteoporosis

Male hypogonadism Causes

Primary causes: This type of male hypogonadism occurs due to an abnormality in the testicles. The causes for this type of male hypogonadism are:

Klinefelter's syndrome

This condition results from a congenital abnormality of the sex chromosomes which are normally present as X and Y in a male. In Klinefelter's syndrome, two or more X chromosomes are present in addition to one Y chromosome. The Y chromosome contains the genetic material that determines the sex of a child and related development. The extra X chromosome that occurs in Klinefelter's syndrome causes abnormal development of the testicles.

Undescended testicles

Before birth, the testicles develop inside the male infant's abdomen and normally move down into their permanent place in the scrotum two months before birth. One or both of the testicles may not be descended at birth. If this problem is not corrected in early childhood, it may lead to malfunction of the testicles. A boy born with an un-descended testicle has a higher risk of infertility and testicular cancer.

Mumps Orchitis

If a person gets mumps infection involving the testicles in addition to the salivary glands, long-term testicular damage may occur. This may affect normal testicular function.

Hemochromatosis

High levels of iron in the blood can cause pituitary gland dysfunction and lead to male hypogonadism.

Testicle injury

As testicles are located outside the abdomen, they are vulnerable to injury. Damage and injury to normally developed testicles can cause hypogonadism. Damage to one testicle may not impair testosterone production.

Cancer treatment

Chemotherapy or radiation therapy for the treatment of cancer can interfere with testosterone and sperm production. The effects of both treatments may lead to male hypogonadism.

Normal aging

Older men generally have lower testosterone levels than younger men. As men progress in age, their testosterone production decreases.

Secondary causes

In secondary hypogonadism, the disorder results due to a problem with the pituitary or hypothalamus gland. Conditions that can cause secondary hypogonadism including:

Kallmann's syndrome

Defective development of the hypothalamus, the area of the brain that controls the secretion of pituitary hormones can cause hypogonadism. Impaired release of hormones by the hypothalamus causes inadequate secretion of pituitary and testicular hormones, resulting in testosterone deficiency.

Pituitary disorders

An abnormality in the pituitary gland can impair the release of hormones which affects testosterone production. A pituitary tumor or other type of brain tumor located near the pituitary gland may cause testosterone or other hormone deficiencies.

Inflammatory disease

Certain inflammatory diseases such as sarcoidosis, histiocytosis, tuberculosis and some fungal infections involve the hypothalmus and pituitary gland and can cause hypogonadism.

HIV/AIDS

This virus can cause low levels of testosterone by affecting the hypothalamus, the pituitary and the testicles.

Medications

Use of drugs like opiate pain medications and some hormones can cause male hypogonadism.

Treatment for male hypogonadism:

There are various treatments for male hypogonadism depending upon the cause and age of the patient.

For hypogonadism caused by testicular failure, doctors use male hormone replacement that is testosterone replacement therapy, or TRT.

Male hypogonadism caused by pituitary problem is treated by pituitary hormone which stimulates sperm production and restores fertility. There are a number of ways by which TRT can be administered to the patient. It may include injections, patch, gel as well as oral medications.

Although there's often no effective treatment to restore fertility in a man with primary hypogonadism, assisted reproductive technology (ART) may be helpful. In boys, testosterone replacement therapy (TRT) can stimulate puberty and the development of secondary sex characteristics, such as increased muscle mass, beard and pubic hair growth, and growth of the penis. Pituitary hormones may be used to stimulate testicle growth.

In adult men, TRT can restore sexual function and muscle strength and prevent bone loss. In addition, men receiving TRT often experience an increase in energy, sex drive and sense of well-being.
Male hypogonadism can cause severe problems if not treated in its early stages. It can occur due to injury to testicles as well as hormone deficiency. Any problem related to male hypogonadism should be properly addressed and treated.