Hypogonadism (Low Testosterone)
UW Health urologist Dan Williams, MD, discusses hypogonadism.
Symptoms of Hypogonadism
- Low energy/fatigue
- Difficulty with concentration
- Decreased work performance
- Sexual dysfunction
- Decreased strength
- Loss of lean body mass
- Decreased sex drive
Primary hypogonadism originates from a problem in the testicles. Common causes of primary hypogonadism include:
- Normal aging
- Injury to the testicles
- Cancer treatment
- Undescended testicles
- Mumps orchitis (mumps infection involving the testicles)
- Hemochromatosis (too much iron in the blood)
- Klinefelter syndrome (abnormality of the sex chromosomes X and Y)
In secondary hypogonadism, the testicles are normal but function improperly due to a problem in the hypothalamus or the pituitary gland, parts of the brain that signal the testicles to produce testosterone. If chemical messages from the pituitary gland to the testicles aren't sent, impaired testicular function occurs.
Common causes of secondary hypogonadism include:
- Abnormality in the pituitary gland
- Kallmann syndrome (abnormal development of the hypothalamus, the area of the brain that controls the secretion of pituitary hormones)
- Inflammatory disease
- The use of certain medications, including narcotics for chronic pain
Either type of hypogonadism may be caused by an inherited (congenital) trait or something that happens later in life (acquired), such as the normal aging process, an injury or an infection.
Testing for Hypogonadism
If you are experiencing any of the symptoms of low testosterone, your physician may recommend checking your testosterone levels.
If tests confirm low testosterone, additional studies can pinpoint the cause.
These studies may include:
- Further hormone testing
- Pituitary imaging
- Genetic studies
If fertility is a concern, other studies may include semen analysis.
If symptomatic men are found to have low testosterone, testosterone replacement therapy is a safe and effective way to return testosterone levels to the normal range. Depending on the underlying cause of the low testosterone levels, your urologist will recommend a specific course of treatment.
Testosterone treatments available at UW Health include:
- Topical gel
- Transdermal patch (skin patch)
- Buccal estosterone (applied on the gum and cheek to get into bloodstream)
- Long-acting injectable pellets