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What is Hypogonadism?

What is Hypogonadism?

According to Boston University School of Medicine, low testosterone (also known as “low T”) impacts between 4-5 million adult men in the United States alone. Male hypogonadism, the scientific name for low T, is a medical condition in which the testicles fail to produce adequate testosterone. 

Although testosterone is often glamorized for its ability to build muscle mass, the male hormone plays a vital role in a wide range of physiological processes. Over time, inadequate testosterone production can contribute to a number of risk factors and medical conditions, as well as an overall decreased quality of life for many males.

Beginning around age 30, a man’s testosterone levels tend to drop around 1% every year thereafter. By the time they reach age 50 they have a 20% chance of developing low T, although many males experience symptoms well before their 50th birthday.

Reasons for Low Testosterone 

When testosterone reaches subclinical levels (usually defined as <300 ng/dL) this is referred to medically as hypogonadism. However, some males may experience symptoms of “low T” with levels well above that reference mark. 

The underlying causes of low T can vary. Below we’ll explore common reasons your testosterone may be low.

1. Primary Hypogonadism

Primary hypogonadism is a condition in which the testicles do not produce sufficient testosterone for optimal health, well-being, or development. Generally, primary hypogonadism is the result of a genetically inherited trait or acquired by illness or physical injury.

Inherited Conditions Include:

  • Klinefelter’s Syndrome: A medical condition where a male is born with not two, but three sex chromosomes (X, X, and Y).
  • Undescended Testicles: Failure of the testes to descend from the abdomen prior to birth
  • Hemochromatosis: A condition marked by too much iron in the blood, causing both pituitary and testicular damage

Testicular Damage Leading to Low T

  • Physical injury to the testes
  • Mumps: an infection that can injure the testicles 
  • Cancer treatments 

2. Secondary Hypogonadism

Damage caused to the hypothalamus and/or the pituitary gland resulting in low T is called secondary hypogonadism. Located in the brain, both of these structures are responsible for coordinating the production of testosterone by the testes.

Inherited Conditions Responsible for Secondary Hypogonadism:

  • Kallmann syndrome
  • Pituitary disorders caused by tumors, drugs, or kidney failure
  • HIV/AIDS
  • Inflammatory diseases including histiocytosis, sarcoidosis, and tuberculosis 

Acquired Circumstances:

  • Aging: as a result of the normal process of aging, particularly after age 40-50
  • Obesity: high body fat percentage can impact hormonal efficacy and production
  • Medications such as opioids and steroids
  • Severe physical or emotional stress such as from illness or surgery 

3. Mixed Hypogonadism

This form of hypogonadism is generally more prevalent among older gentlemen. However, those with sickle-cell disease, alcoholism, thalassemia, or who are undergoing glucocorticoid therapy are at increased risk.

Closing Thoughts Regarding Low Testosterone

Low testosterone can be caused by a broad range of inherited and secondary conditions. If you feel like you may be at risk for, or are experiencing symptoms associated with low T, reach out to our team in North Carolina today and schedule a consultation. 

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Dr. Douglas Miller

Dr. Douglas Miller

Dr. Miller is a board-certified physician with training in
Internal Medicine, Emergency Medicine and
Advanced Bioidentical Hormone Replacement Therapy.

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