About the disease

Hypogonadism is a condition, whereby a man does not produce sufficient amount of testosterone. This hormone is responsible for masculinity and also normal development during the puberty period. Testosterone is produced in the testicles. A man is diagnosed with hypogonadism if he can not produce sperm as well.

There are two types of hypogonadism: congenital and acquired. In case of congenital hypogonadism child is already born with testosterone deficiency. If a child is born with hypogonadism, he may have impaired growth of genitals, which can be either underdeveloped or even be female, although a child is genetically male. Such cases are very rare, but they exist. Congenital hypogonadism can also affect the development of masculinity during puberty. The most common sign that a teenage boy does not have sufficient amount of testosterone is lack of muscle mass and also lack of deep voice. There can be decreased growth of beard and chest hair as well. The size of penis can also be small in case a teenage boy does not have sufficient level of testosterone. It can also affect the behaviour and a character of a boy, making him more feminine-like.  In case of acquired hypogonadism, it develops as a result of trauma or injury. In acquired form of hypogonadism a man can develop hypogonadism as a result of an infection as well. In case of acquired hypogonadism, a man can experience erectile dysfunction and low sex drive. In severe cases a man can also develop infertility.  

Symptoms

• Decreased hair growth
• Decreased mass growth
• Decreased growth of genitals
• Feminine-like behaviour
• Low sex drive
• Infertility
• Erectile dysfunction

Diagnosis

• During a general examination, a doctor will examine the testicles and the penis of a patient. A doctor will determine if the size of testicles and penis is normal for for his age. A doctor will also determine if the mass growth of a man is normal and if there is sufficient amount of hair.
• Blood test and semen sample testing are used to determine if a boy or a man has low levels of testosterone. Genetic testing can be done as well if hypogonadism is present from birth.
• Biopsy is sometimes used if there is suspicion of malignancy in the testicles.

Treatment

• Conservative treatment uses testosterone replacement therapy to elevate the levels of testosterone to normal. There are many ways which a man can receive testosterone. This includes injections, special patches which need to be applied each night, gels and pellets which can be injected into the skin each 3-6 month, depending on the type and amount of testosterone a man has. This treatment can restore normal hair and muscle growth and also return sex drive.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed