Primary hypogonadism in men happens when the primary cause of reduced gonadal functions is located in the testicles. The gonads or testes are the ones responsible for the synthesis of sex hormones and the formation of sexual gametes. Hypogonadism means the testes are not sufficiently performing these functions.
Because the synthesis of sex hormones is negatively affected, testosterone levels in men with hypogonadism are often extremely low. And since there is testosterone deficiency, sperm production is also affected. Read on to learn more about the common causes and effects of hypogonadism.
Common Causes Of Hypogonadism
There are several causes of hypogonadism, however, obesity is one of the most common. Male obesity secondary hypogonadism is a condition that men should do their best to avoid. Not only does it lead to cognitive function deterioration, the condition also greatly reduces fertility and impairs sexual function.
Cryptorchidism or undescended testicles is a congenital defect wherein the testes are found in the abdomen instead of inside the scrotum. When the condition is left untreated, it leads to testicular malfunction. This then results in hypogonadism and reduced testosterone production.
Klinefelter’s Syndrome is a genetic aberration wherein men have two X chromosomes instead of just one. Female characteristics are found in the X chromosome whereas male characteristics are determined by the Y chromosome.
Although the development of the masculine characteristics is dictated by the Y chromosome, this becomes affected by the extra X chromosome that men with Klinefelter’s syndrome have. This can influence the development of the male reproductive organs such as the testes. Because the testicles develop abnormally, their functions are also affected, leading to hypogonadism.
Hereditary hemochromatosis, simply put, is having an overload of iron in the blood. The condition causes dysfunction of the endocrine glands and hypogonadism is a common complication of hemochromatosis.
When there’s too much iron in the blood, it may lead to the formation of iron deposits near the seminiferous tubules where sperm cells are formed and stored. The iron deposits cause testicular damage and contribute to the development of hypogonadism.
Moreover, hemochromatosis is associated with an increased concentration of iron in the testes as well as higher oxidative stress. This leads to oxidative damage to the testes, particularly to the lipids and proteins found in the testes.
Injury To The Testicles
When the testicles are injured or damaged, it may lead to hypogonadism. Testicular injuries may result from trauma, testicular torsion, or testicular cancer. In testicular trauma, the trauma may be caused by a blunt blow or by penetrative trauma.
One example of trauma that can lead to testicular injury is when the testicles receive a direct blow. Most likely to happen in contact sports, testicular rupture can lead to blood leaking into the scrotum. Testicular rupture is also often accompanied by severe pain in the testes and groin area and scrotal swelling is also common. When this happens, surgery is recommended to correct the injury.
Radiation therapy or chemotherapy are often necessary to treat cancer. Unfortunately, chemotherapy for testicular cancer may also result in injuries to the testicles. Male cancer patients aged fifty years and above are even more prone to develop hypogonadism due to cancer treatment.
Moreover, the compounds used in chemotherapy are known to cause primary hypogonadism, which is why a significant number of cancer patients often develop hypogonadism. Furthermore, medications often prescribed to cancer patients such as opioids and glucocorticosteroids are also associated with secondary hypogonadism.
Detrimental Effects Of Hypogonadism
Hypogonadism primarily affects the testosterone levels in the body. And since testosterone has many important functions, its deficiency leads to many problematic conditions. The decrease in body hair growth may be considered as one of the least worrisome effects of hypogonadism, but there are other severe effects such as infertility.
Low levels of testosterone are the number one symptom common to all men with hypogonadism. The next most common symptom is reduced sperm production which leads to oligospermia and azoospermia.
The former refers to having a low concentration of sperm in the semen, while the latter refers to the absence of sperm in the semen. This explains why men with hypogonadism are often infertile – they often don’t have enough sperm cells in their semen which greatly reduces the likelihood of fertilization.
In cancer-related hypogonadism, infertility is also a common result. Whether it’s due to primary or secondary hypogonadism, cancer treatment often leads to infertility because of reduced testosterone and sperm production. Thus, young male cancer patients are often advised to have their sperm preserved because of the known adverse effects of chemotherapy and cancer treatment on fertility.
Impaired Sexual Function
Hypogonadism is associated not just with low testosterone levels but also with reduced libido. When the patient is an aging male, hypogonadism may be accompanied by androgen deficiency which further increases the likelihood of sexual dysfunction.
Aside from reduced libido, men with hypogonadism may also suffer from reduced penile sensation, impotence or erectile dysfunction, and ejaculatory problems. In adult men, the effects of testosterone are manifested through the libido and penile erections as well as through physical strength and vitality, and even through aggression.
Since testosterone levels are low in hypogonadic men, the opposite behaviors are manifested instead. Thus, hypogonadic men usually have decreased desire for sex and suffer from erectile problems.
Muscle Mass Deterioration
The deterioration of muscle mass is especially common in male obesity secondary hypogonadism. Moreover, the condition also leads to a reduction in bone mineral density as well as impaired fat metabolism.
The extremely low testosterone levels associated with hypogonadism are also linked to physical inactivity and decreased muscle development, both of which contribute to muscle atrophy. More specifically, men with low testosterone levels often experience quadriceps muscle weakness. Moreover, hypogonadism can also lead to reduced energy and vitality as well as fatigue.
Bodybuilders and men who exercise a lot often have the appearance of having large chests because of their well-developed pectoral muscles. Men who have gynecomastia, in contrast, have enlarged chests because their breast glands got enlarged due to hormonal imbalance.
Gynecomastia is a condition characterized by the enlargement of the breasts in men. Because hypogonadism causes testosterone levels to be extremely low, it results in hormonal imbalances. This often leads to gynecomastia, which is common to men with late-onset hypogonadism.