Hypogonadism: Causes
There are several causes of hypogonadism, these include primary causes (where the problem originates in the testicles), secondary causes (where the problem originates in the brain) and mixed causes. Both primary and secondary causes can be present from birth or can occur later in life.
Primary hypogonadism occurs when the testicles (testes) do not work properly. Some causes of primary hypogonadism are:
- Klinefelters syndrome. Men who are born with this syndrome have at least one extra X chromosome. This causes abnormal testicular development resulting in lower testosterone production, and occurs in approximately one out of every 1,000 men
- Undescended testicles
- Twisting or injury of the testicles
- Surgical removal of both testicles, for example, for cancer treatment
- Radiation of the pelvis and testicles
- Some chemotherapies negatively affect the testicles
- Mumps orchitis (an infection that involves the testicles) or other viruses in youth or adolescence
Secondary hypogonadism occurs when there is a problem in the hypothalamus or pituitary gland in the brain. In this case, the testicles are normal but are not being properly stimulated by hormones produced in the brain. Some causes of secondary hypogonadism are:
- Pituitary disorders or tumors
- Radiation or surgery to the pituitary gland or hypothalamus
- Kallmann syndrome. Men who are born with this syndrome lack a hypothalamic hormone (gonadotropin releasing hormone or GnRH) that stimulates the production of other hormones such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH)
- Use of certain drugs, for example, opiate pain medications, NSAIDs, some antifungals and anticonvulsants, prednisone, cholesterol lowering drugs, and anti-androgens.
- Hemochromatosis (too much iron in the blood)
- Obesity
- Use of illegal steroids by athletes can cause the pituitary to stop producing the hormones (LS and FSH) that stimulate testosterone production in the testicles, causing hypogonadism
Some mixed causes of hypogonadism include:
- chronic alcohol abuse
- HIV/AIDS and other systemic diseases
- normal aging
