Womens Health


One condition that can affect male fertility is hypogonadism. In fact, hypogonadism can affect a man’s fertility by hindering testicular and sperm health. But what exactly is hypogonadism, what symptoms are associated with this condition, and how can it be treated? And how does hypogonadism affect a man’s fertility?

What is Hypogonadism?

Hypogonadism is a testosterone deficiency that affects approximately 1.3 million men in the United States alone. However, the exact number of individuals with this condition is not known because less than 10% of men with this disorder seek treatment.

Men with hypogonadism experience an insufficient production of a hormone known as gonadotropin; low levels of this hormone are associated with low levels of testosterone, thereby causing sperm production abnormalities, low sex drive and erectile dysfunction. Irregular gonadotropin levels occur when the pituitary gland, testicles or hypothalamus have experienced damage or disease.

Causes of Hypogonadism

There are two types of hypogonadism: primary and secondary. These forms of the condition are classified according to their causes.

Primary hypogonadism results from low testosterone levels, which in turn cause abnormal testicular function. The following are causes of primary hypogonadism:

  • injury to the testicles
  • undescended testicles
  • chemotherapy
  • radiation therapy
  • excessive levels of iron in the blood (hemochromatosis)
  • Klinefelter’s syndrome (a chromosomal disorder characterized by the presence of an extra X chromosome, which results in reduced testicular growth and sperm production problems)

Secondary hypogonadism occurs as a result of a problem in the hypothalamus or the pituitary gland, which results in a decreased secretion of pituitary hormones. This in turn results in the testicles not receiving the signals required for normal performance. Causes of this condition include:

  • pituitary disorders
  • inflammatory disease
  • the use of certain medications
  • Kallman’s syndrome (a condition that affects hypothalamus development)

Symptoms of Hypogonadism

There are a variety of symptoms associated with hypogonadism:

  • reduced muscle mass
  • increased body fat
  • reduced facial and body hair
  • erectile dysfunction
  • development of enlarged breasts
  • shrinking and softening of the testicles
  • reduced energy levels
  • reduced sex drive
  • menopause-like symptoms (hot flashes, mood swings and irritability)
  • depression
  • osteoporosis

Treatment of Hypogonadism

Because hypogonadism can have a negative effect on male fertility, treatment is essential. Diagnosis is the first step in the treatment of hypogonadism. A testosterone test is administered, which is a blood test used to analyze testosterone levels. In addition, a sperm count test is often performed.

Testosterone replacement therapy (TRT) is the most common form of treatment and involves the administering of synthetic testosterone to supplement levels of the hormone already present in the body.

TRT is administered most commonly in gel and patch form and is also available in an injectable form.

However, generally male fertility will not return, making assisted reproductive technology (ART) procedures a viable option for couples seeking to conceive.

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