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Hypogonadism simply means that the “gonads”, namely the male (testicles) or the female sex hormone producing glands (ovaries), do not deliver enough hormone to sustain male or female sex characteristics.

In the male, testosterone deficiency can be due to absent testicles or testicles that are malfunctioning. In the female, estrogen deficiency means that the ovaries are not present or not functioning properly. There are a number of reasons why this could happen as summarized in the table below.

Causes of hormone deficiencies of testicles and ovaries *

Male hypogonadism Female hypogonadism
 primary  hypogonadism Klinefelter syndrome  primary  hypogonadism Turner syndrome
Bilateral anorchia (absent testicles)
Congenital adrenal hyperplasia
 secondary  hypogonadism Panhypopituitarism Congenital adrenal hyperplasia
Kallman syndrome  secondary  hypogonadism Panhypopituitarism
Male menopause (=Andropause) Menopause

This table explained below

At first glance this table might look somewhat menacing, but it is not that complicated. Let me explain: Both male and female hypogonadism can be divided into primary and secondary hypogonadism.

“Primary” means that the hormone deficiency originates directly at the site where the sex hormones are produced (testicles, ovaries or the adrenal glands). “Secondary” means that the hypogonadism develops because of a lack of stimulation of hormone production due to adrenal gland disease or due to missing pituitary or hypothalamic hormone stimulation. Perhaps the most common age-related reason for gonadal slow-down is menopause for females and andropause for males. The table above contains links to more info regarding the more common causes of hypogonadism.


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More references

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Last modified: April 12, 2021

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.