What is Hypogonadism?

In men 45 and older, most cases of hypogonadism or Low-T often go overlooked due to the fact that the symptoms may be more general in nature and slower in onset. Many men simply attribute their symptoms to aging and often dismiss them because they don't think that there is anything that they can do about them. This is largely because the symptoms of hypogonadism are nearly identical to those experienced by men going through andropause (the male menopause): low libido, fatigue, depression, memory loss, difficulty concentrating and irritability. The difference between andropause and hypogonadism is simple. Andropause is a natural part of a man's life where his hormones begin to decline right around the age of 35 and continue to decrease until they plateau in his late 60's. Hypogonadism is a condition where testosterone is not being produced due to a physical abnormality of the testes or brain. It can also be due to an outside factor such as stress, poor diet or pre-existing health conditions. Both Hypogonadism and andropause however can be treated and corrected under the care of experienced hormonal specialists.

What Causes Hypogonadism?

There are two basic forms of hypogonadism found in men. Primary hypogonadism is also known as ?testicular failure? and stems from a complication in the testicles. Some common causes of primary hypogonadism are:

Primary Hypogonadism

  • Aging ? As men age, their testosterone levels slowly begin to decline. In men, the hormonal shift is much more gradual (an average of 1-2% per year) than women experience during menopause, however the effects can be just as trying, resulting in symptoms such as fatigue, low libido, irritability and depression.
  • Klinefelter syndrome ? A condition that is caused by a congenital abnormality of the sex chromosomes, X and Y. In Klinefelter syndrome, men have an extra Y chromosome (either 2 or more). This excess chromosome (or chromosomes) can lead to abnormal development of the testicles, resulting in the underproduction of testosterone.
  • Testicle displacement ? Sometimes a man's testicle or testicles don't descend down to their permanent place in the scrotum. Usually this condition will correct itself autonomously during the first few years of life, but if the condition continues into adult-hood and is not corrected, it can lead to testicular damage and subsequent testosterone deficiency in men.
  • Chemotherapy ? Chemo and radiation treatments used to treat cancer can disrupt the production of sperm and testosterone. Although the effects from cancer treatments are often temporary, they can still result in a hormonal imbalance and in many cases irreversible infertility.

Secondary Hypogonadism

The other type of hypogonadism is called secondary hypogonadism, and it describes a condition where the testicles are normal on a physiological level, but still don't function properly due to a problem stemming from the pituitary gland or the hypothalamus. This creates a problem with the signal from the brain to the testicle. Although the testicles function well, they can't get the information from the brain that testosterone needs to be produced. Some common causes of secondary hypogonadism are:

  • Kallman syndrome ? A condition where the hypothalamus gland is abnormally developed or under-developed. The condition can also lead to anosmia, or the impairment of the sense of smell.
  • Pituitary disorders ? Pituitary tumors or brain tumors found near the pituitary gland can lead to hormonal deficiencies including testosterone.
  • Inflammatory disease ? Inflammatory diseases such as sarcoidosis, histiocytosis and tuberculosis can impact the hypothalamus and pituitary gland and diminish testosterone production.
  • Medications ? Using certain pharmaceuticals such as those that trigger opioid receptors like pain killers, can affect the production of testosterone.
  • Stress ? Stress can affect many aspects of testosterone production. It can cause a problem with the hypothalamus with subsequent signal reduction to the testes. Also, since the stress hormone, cortisol, has the same building blocks as testosterone, a high cortisol demand can lead to a depletion of testosterone because there aren't enough building blocks left to make it.
  • Obesity ? Your weight plays a significant role in maintaining your endocrine function. Excess body fat causes existing testosterone to be converted to estrogen and reduces the ability of the testicles to produce adequate testosterone as well.

The Solution: Hypogonadism Treatment

The most effective ways to treat hypogonadism are to enhance the body's ability to make its own testosterone or to supplement the testosterone that your body would produce normally, using natural bioidentical testosterone replacement therapy. It is critical to combine bioidentical hormone therapy with appropriate diet, exercise, lifestyle and stress management. Although there are many different causes for the condition, hypogonadism always leads to hormonal imbalance and can lead to a wide range of symptoms and chronic health issues. 

Through comprehensive testing, your affiliated physician will determine your hormone levels to uncover potential hormone deficiencies.

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