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Sometimes referred to as testosterone deficiency, male hypogonadism is a condition that occurs when the testes are not able to produce normal levels of testosterone and/or sperm.

What are the Causes of Male Hypogonadism

It is possible to be born with male hypogonadism but it can also develop later in life as the result of an infection, injury or disease.

In cases of primary hypogonadism, the testicles will not respond to hormone stimulation. Primary hypogonadism can result from either a congenital disorder or be acquired after trauma to the testes, mumps, tumours, chemotherapy or radiation treatments.

Cases of secondary hypogonadism are caused by a disease interfering with either the pituitary gland or the hypothalamus, which are both glands that release hormones that will stimulate the production of testosterone in the testes. Secondary hypogonadism can be caused by:

  • systemic illness
  • stress
  • malnutrition
  • cirrhosis of the liver
  • morbid obesity
  • toxins from heavy metals and alcohol
  • certain medications, including anabolic steroids


Andropause, also known as male menopause, is a term sometimes used to describe the natural decrease in testosterone levels as a direct result of the ageing process. Testosterone in males typically increases until the age of 17. Levels then begin to decline in males over 40 at a rate of between 1.2 and 2% per year. The results of one study in 2012 indicated that around 20% of men over the age of 60 and 50% of men over the age of 80 present low levels of serum testosterone.

What are the Symptoms of Male Hypogonadism?

Hypogonadism can cause a wide range of different symptoms. The form and the severity of these symptoms will depend largely on:

  • whether onset was pre- or post-puberty
  • the degree of the testosterone deficiency
  • the length of time a person has been experiencing hypogonadism


If hypogonadism occurs pre-puberty, puberty will not progress normally. Adolescents and young adults will typically appear younger than their age and might also:

  • lack facial hair
  • have small genitalia
  • notice that their voice does not break and deepen
  • experience difficulties gaining muscle mass


In some cases, puberty-onset male hypogonadism can also lead to:

  • enlarged breasts
  • small testicles
  • impaired sexual development


If hypogonadism occurs in adulthood, the symptoms can include:

  • loss of libido
  • erectile dysfunction
  • decreased sperm count
  • increased body fat
  • small, soft testes
  • reduced physical strength and muscle mass
  • osteoporosis
  • increased sweating
  • a wrinkled appearance to the skin
  • tiredness
  • loss of concentration and/or motivation
  • changeable moods

How is Male Hypogonadism Diagnosed?

Many of the symptoms of male hypogonadism can have multiple different causes, which is why diagnosis of male hypogonadism can sometimes be delayed or missed initially.

Biochemical testing will be performed to accurately assess testosterone levels in the blood. As testosterone levels can fluctuate throughout the day, this testing is usually performed in the morning and before any food has been consumed.

How is male Hypogonadism Treated?

Testosterone replacement therapies can be used to successfully treat male hypogonadism. The precise form of treatment will vary from patient to patient, but the aim is ultimately to raise the amount of testosterone in the blood to a normal level.

If you are displaying any symptoms of male hypogonadism, visiting your doctor to discuss your concerns and to obtain an official diagnosis is an important first step towards getting the appropriate treatment for your condition.

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