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What Is Male Hypogonadism?

Jan 13 2020

What Is Male Hypogonadism?

Testosterone Deficiency, also known as Male Hypogonadism

Male hypogonadism medically describes a testosterone deficiency in men resulting from the failure of their testes to produce adequate levels of testosterone, sperm, or both. The ramifications of such a condition have resounding impacts on the development of young prepubescent boys as well as towards the overall health and wellness of adult men. To better understand how the harmful symptoms of hypogonadism arise, the physiological pathway of testosterone production should illuminate how testosterone is delivered, regulated, and how the effects of disease or trauma against the pathway of testosterone production are problematic.

The importance and Pathophysiology of Testosterone

The male gonads are the primary source for both testosterone and sperm production. Clinically low testosterone (low T) levels have physical effects on the development or appearance of sexual characteristics, fertility, muscularity, etc. Through a male’s lifespan, testosterone facilitates more than just sexual maturation: it also has a critical role in both cognitive and physical development. During fetal development, testosterone serves as an aid for the determination of sex. In prepubertal stages, testosterone contributes towards physical maturation via growth spurts, increased muscle mass, deepening of the voice, sexual organ growth, facial hair, height increase, etc. And into later adulthood, testosterone plays the ever-important role in regulating libido, aggression, and physical and mental energy levels. While it can be recognized why testosterone is essential for a variety of reasons, by understanding how the body produces testosterone, physicians can identify which classification of hypogonadism a patient has depending on which area testosterone production is sorely lacking in.
Stemming from the cerebral cortex — the area of the brain commonly identified as the gray matter — testosterone production is signaled here. The hypothalamus is signaled by the cerebral cortex to stimulate testosterone through a series of neural activations. Gonadotropin-releasing hormone is triggered to stimulate the pituitary gland (a portion of the brain primarily involved with hormones that regulate critical biological functions such as growth or metabolism). Consequently, the pituitary gland in response releases two hormones: FSH and LH. LH or luteinizing hormone activates specific cells within the testes where an organic molecule is then converted into testosterone. As testosterone levels reach an appropriate level (average level being around 679 nanograms per deciliter), the pituitary dials back how much LH is released to control for overproduction of testosterone.
Given the complex nature of the process involving the biological negative-feedback loop (pituitary gland releasing LH to raise testosterone which, in turn, brings testosterone to an appropriate level that then prompts the pituitary gland to halt LH), there arise potential problems that can affect any area of the testosterone production cycle. Any harm or disruption to the testicles, hypothalamus, or pituitary gland results in hypogonadism. And depending on where the problem arises in the testosterone production sequence causes the manifestation of differing hypogonadal conditions.

Effects of Hypogonadism

The two types of hypogonadism that males can be diagnosed with are the following: Primary or secondary hypogonadism. Hypogonadism’s severity is dependent upon the age of onset, the intensity of hormone deficiency, and the range of functionality of the testes.
Primary hypogonadism is viewed as primarily testicular failure stemming from a problem within the testicles themselves. Such factors that contribute to this form of affliction are congenital abnormalities of the sex chromosomes during development, undescended testes at birth, damage to one or both the testicles, a cancer treatment that interferes with hormone production, and lastly, old age.
Secondary hypogonadism occurs when the testicles are normal but still misfunction due to issues with the pituitary gland or the hypothalamus. Some of the many contributors towards secondary hypogonadism entail pituitary disorders that exacerbate inflammatory diseases, HIV/AIDS, certain medications that affect testosterone, and obesity.
As mentioned earlier, depending on the age of onset of hypogonadism can have considerable differences in the manifestation of symptoms that males experience. During fetal development, males with hindered testosterone production can be born with underdeveloped male genitals or ambiguous genitalia. At puberty, male hypogonadism can delay maturation or skip healthy development, causing affected pubescent males to experience decreased muscle mass growth, lack of their voice deepening, diminished growth of both body and facial hair, underdevelopment of sex organs, and even gynecomastia (exaggeration of breast tissue). Into adulthood, men that develop hypogonadism may first note early signs and symptoms: a lowered sex drive, reduced energy, and depression.
If left untreated, men can develop erectile dysfunction, infertility, loss of hair, lowered muscle mass, osteoporosis, and gynecomastia. In the most severe examples, men can experience mental and emotional changes similarly to symptoms of menopause (mood swings, hot flashes).

Hormone Therapy Treatment

It’s evident how devastating this condition can have towards not only developing young males but the effects it has on men who have lived otherwise completely healthy and normal lives. Considering the large impact hypogonadism has on quality of life, early diagnosis and treatment can reduce risks associated with hypogonadism. Young boys afflicted with the condition can receive proper treatment to help facilitate their development through puberty. At the same time, older men can avoid experiencing a plethora of symptoms harmful to their wellness and physicality.
If testing has been performed and it’s revealed that testosterone levels fall below the healthy baseline, then the sooner treatment is started, the better. Testosterone replacement therapy (TRT) is the primary treatment in combating hypogonadism. By introducing testosterone into patients with low testosterone, elevated T-levels courteous of TRT can help restore a patient’s testosterone baseline. As TRT is maintained, men will begin to experience restored sexual function, libido, behavior, and well-being. There are several options to choose from regarding TRT, which involve implantable pellets and intramuscular injections.
Under the guidance and direction of a trusted health care provider, hypogonadism doesn’t have to be a condition that males suffer through silently. Contact us at Vitality Aesthetic & Regenerative Medicine in Palm Harbor Florida to find out how to start treatment now.