Causes of Hypogonadism

Causes of hypogonadism include aging, cancer treatment, undescended testicles, injury to the testicles, and Klinefelter's syndrome. Many other factors such as obesity, diabetes, head injuries, and immune system probles can contribute to the risk for hypogonadism. 

Declining testosterone levels related to aging

Male menopause, male climacteric, mild gonadopause, viropause, andropause, mild testicular failure, late-onset hypogonadism, ADAM syndrome, and PADAM syndrome are names of medical conditions associated with age-related testosterone decline. 

ADAM syndrome is androgen deficiency of the aging male. PADAM syndrome is partial androgen deficiency in the aging male. 

All these medical conditions suggest a phenomenon that parallels female menopause. 

About 4 to 5 million men in the United States have testosterone deficiency, while less than 15 percent are being treated for the disease. 

Testosterone replacement therapy (TRT) and androgen replacement therapy isn't well accepted for treating normal aging. Some doctors worry about treating patients with hypogonadism because long term studies haven't been done on TRT. This concern parallels the estrogen replacement therapy (ERT) controversy that surrounds treating menopausal women with estrogen. 

Causes of Hypogonadism

Injury to the Testicles

An injury to the gland can result in testicle dysfunction. The testicles are located outside the abdomen, which makes them prone to injury. Damage to normally developed testicles can cause hypogonadism. 

Urologic Problems

Causes of hypogonadism include urologic conditions like varicocele, hydrocele, spermatocele, and even testicular cancer can cause swelling in the testicles, which can cut off blood supply. Not everyone with these conditions gets hypogonadism, but these conditions do increase risk. 

You can get checked for these conditions with a complete examination of the testicles and scrotum followed by a testicular ultrasound. 


Although some doctors disagree, a vasectomy is thought to increase your risk for hypogonadism. The surgery may disrupt blood supply to the testicles, causing a decline in function. Infections and bleeding are more severe complications of vasectomy or vasectomy reversal surgery that can lead to more severe cases of hypogonadism. 

Head injuries

Head injuries are a very common cause of pituitary gland dysfunction. Men with head injuries may develop low testosterone levels. It is also very common to see growth hormone deficiency in conjunction with a head injury. 

Many symptoms of growth hormone deficiency overlap with the causes of hypogonadism. 


Testosterone deficiency is an extremely common condition in men with diabetes. Men with type 1 diabetes are at risk for hypogonadism. Type 1 diabetes is an autoimmune condition. This disease is an immune system disorder that destroys testosterone producing cells. 

Men with Type 2 diabetes are also at risk. Insulin resistance, high blood sugar, and chronic illness combined with excess weight and the decline in age-related androgen all take part in the process of developing hypogonadism. 

Men that have diabetes gain fat and lose muscle, having difficulty getting control of their blood sugar levels. Testosterone therapy reverses hypogonadism symptoms and also improves insulin resistance and diabetic control. 

Obesity Causes of Hypogonadism

Causes of hypogonadism include obesity which can lower androgen levels in many ways. Being overweight worsens the age-related decline of androgens. Leptin and cortisol are other hormones that can significantly lower androgen levels. These two hormone levels increase as you gain weight. 

Also, fat cells produce hormones that lower testosterone levels. 

Overweight men have increased levels of aromatase, the enzyme that converts androgens into estrogens. High estrogen levels result from low testesterone and low growth hormone levels. 

Diagnosing and treating hypogonadism in men can be very challenging. Standard testosterone preparations such as testosterone patches and testosterone gels may not penetrate the skin adequately in obese men, so alternate therapies may be required. 

› Causes of Hypogonadism

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