Male Reproductive Disorders: Hypogonadism

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  • 0:02 Male Hypogonadism
  • 0:50 Why Does It Occur?
  • 4:00 Signs & Symptoms
  • 4:56 Diagnosis & Treatment
  • 6:39 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

A high-pitched voice, breasts, little body hair, and smaller muscle mass are all things typically associated with women. Yet men can also have these characteristics because of a medical condition known as hypogonadism, which you'll learn about in this lesson.

Male Hypogonadism

Wide shoulders, big muscles, beards, and protruding eyebrows can be attributed to cavemen, guys at a beach gym, or just maybe a lot of men in general. They're signs of the influence of characteristically male hormones that lead to these features.

However, some men do not have very bushy beards or big muscles. That doesn't mean there is something wrong with them - genes influence such features quite a bit - but there is a medical condition where some men truly don't have enough hormones to stimulate the development of stereotypically male features. This condition is known as male hypogonadism, and, simply put, it's a medical condition where the body doesn't produce enough of the hormone testosterone.

Why Does Hypogonadism Occur in Men?

First, let's break down the term 'hypogonadism' to help you understand why it's called that. The prefix 'hypo-' refers to an abnormally low amount of something, and 'gonads' are sex organs that produce gametes. In our lesson's case, the gonads are the testicles that produce gametes, or reproductive cells, that we know as sperm and the hormone called testosterone.

Now, in hypogonadism, it's not necessarily that the testicles are missing (although they can be the cause of this condition); instead, their function is diminished. This, of course, may very well lead to abnormally low levels of sperm and resulting infertility. Think about an icemaker in your fridge. If you don't have one, no ice is going to be made at all. But if you have one and it doesn't respond to the electronic and electrical signals telling it to churn out some ice, then it's not going to! Not having any little pieces of ice being made is like not having any little sperm cells or tiny molecules of testosterone being made by the testicles.

There are two main reasons for this low function and low output of testosterone and sperm. The first is called primary hypogonadism. This is a type of hypogonadism that occurs as a result of a problem with the testicles themselves. Causes for this include:

  • Klinefelter syndrome, a genetic disorder that is the most common cause of male hypogonadism.
  • Anorchia, the absence of both testicles at birth.
  • Cryptorchidism, where one or both testicles do not descend into the scrotum. A separate lesson covers the details of this condition.
  • Mumps, chemotherapy, and certain medications.

Thus, in primary hypogonadism, two hormones (known as LH and FSH) are unable to stimulate the testicles to function properly and produce enough testosterone. The LH (luteinizing hormone) and FSH (follicle-stimulating hormone) are like the signals telling the ice maker to produce ice cubes. Contrast this with secondary hypogonadism. In secondary hypogonadism, the brain's pituitary gland doesn't produce enough FSH and LH to stimulate the testicles, or the brain's hypothalamus doesn't produce enough of the hormone GnRH to stimulate the pituitary gland to secrete the FSH and LH.

To put it another way, in secondary hypogonadism, the testicles are fine. The ice maker works! It's the brain that's the problem; it's the powerful signal to make ice that isn't present, which is a big bummer and no laughing matter. Reasons for this include Kallmann syndrome, the abnormal development of the hypothalamus, and pituitary disorders, like a tumor. Of note is the fact that injuries, infections and diseases, and some drugs can cause primary, secondary, or a mix of both types of hypogonadism.

Signs and Symptoms

Because the testicles aren't functioning properly or don't get to function properly, this leads people with hypogonadism to experience the following things:

  • Underdeveloped male genitals, the presence of normal-looking external female genitals, or ambiguous genitals if hypogonadism happens during fetal development - all of this despite the child being genetically male.
  • Impaired development and growth of body hair, a male voice, muscle mass, the penis, and testicles during puberty. Gynecomastia, abnormally large breast tissue development in men, is another possibility that develops with time.
  • Finally, infertility, erectile dysfunction, decreased muscle mass and body hair, smaller testicles, gynecomastia, osteoporosis, mood changes, and decreased cognitive skills in adult men.

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