Skip to main content

Hypogonadotropic and Hypergonadotropic Hypogonadism

  • Chapter
  • First Online:
Testosterone

Abstract

Male hypogonadism is a clinical syndrome that results from failure of the testis to produce physiological levels of testosterone and adequate spermatogenesis as a result of disruption of one or more levels of the hypothalamic-pituitary-testicular axis. Diagnosis of hypogonadism can be difficult given that the symptoms and signs are nonspecific and can change depending on age, comorbid illness, severity, and duration of hypogonadism (Bhasin et al., J Clin Endocrinol Metab, 95(6):253, 2010). A thorough history and physical examination will be needed to help determine the etiology.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Bhasin S, Cunningham G, Hayes F, Matsumoto A, Snyder P, Swerdloff R, et al. Testosterone therapy in men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2010;95(6):2536–59.

    Article  CAS  PubMed  Google Scholar 

  2. Melmed S, Williams RH. Williams textbook of endocrinology. In: Melmed S et al., editors. Textbook of endocrinology. 12th ed. Philadelphia, PA: Elsevier/Saunders; 2011.

    Google Scholar 

  3. Araujo A, Esche G, Kupelian V, O’Donnell A, Travison T, Williams R, et al. Prevalence of symptomatic androgen deficiency in men. J Clin Endocrinol Metab. 2007;92(11):4241–7.

    Article  CAS  PubMed  Google Scholar 

  4. Zitzmann M, Faber S, Nieschlag E. Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab. 2006;91(11):4335–43.

    Article  CAS  PubMed  Google Scholar 

  5. Hall S, Esche G, Araujo A, Travison T, Clark R, Williams R, et al. Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample. J Clin Endocrinol Metab. 2008;93(10):3870–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Brambilla D, O’Donnell A, Matsumoto A, McKinlay J. Intraindividual variation in levels of serum testosterone and other reproductive and adrenal hormones in men. Clin Endocrinol (Oxf). 2007;67(6):853–62.

    Article  CAS  PubMed  Google Scholar 

  7. Bhasin S, Zhang A, Coviello A, Jasuja R, Ulloor J, Singh R, et al. The impact of assay quality and reference ranges on clinical decision making in the diagnosis of androgen disorders. Steroids. 2008;73(13):1311–7.

    Article  CAS  PubMed  Google Scholar 

  8. Rosner W, Auchus R, Azziz R, Sluss P, Raff H. Utility, limitations, and pitfalls in measuring testosterone: an endocrine society position statement. J Clin Endocrinol Metab. 2007;92(2):405–13.

    Article  CAS  PubMed  Google Scholar 

  9. Handelsman D, Liu P. Klinefelter’s syndrome—a microcosm of male reproductive health. J Clin Endocrinol Metab. 2006;91(4):1220–2.

    Article  CAS  PubMed  Google Scholar 

  10. Bhasin S. Testicular disorders. In: Larsen PR, Kronenberg HM, Melmed S, Polanski KS, editors. Williams’ textbook of endocrinology. 11th ed. Philadelphia, PA: Elsevier; 2008.

    Google Scholar 

  11. Matsumoto AM. The testis. In: Felig P, Frohman LA, editors. Endocrinology and metabolism. 4th ed. New York, NY: McGraw-Hill; 2001. p. 635–705.

    Google Scholar 

  12. Bojesen A, Juul S, Gravholt C. Prenatal and postnatal prevalence of Klinefelter’s syndrome: a national registry study. J Clin Endocrinol Metab. 2003;88(2):622–6.

    Article  CAS  PubMed  Google Scholar 

  13. Oates RD. The natural history of endocrine function and spermatogenesis in Klinefelter’s syndrome: what the data show. Fertil Steril. 2012;98(2):266–73.

    Article  CAS  PubMed  Google Scholar 

  14. Bachir BG, Jarvi K. Infectious, inflammatory, and immunologic conditions resulting in male infertility. Urol Clin North Am. 2014;41(1):67–81.

    Article  PubMed  Google Scholar 

  15. Vassilakopoulou M, Boostandoost E, Papaxoinis G, de La Motte Rouge T, Khayat D, Psyrri A. Anticancer treatment and fertility: effect of therapeutic modalities on reproductive system and functions. Crit Rev Oncol Hematol. 2016;97:328.

    Article  PubMed  Google Scholar 

  16. Nieschlag E, Vorona E. Mechanisms in endocrinology: medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol. 2015;173(2):R47–58.

    Article  CAS  PubMed  Google Scholar 

  17. Carp HJ, Selmi C, Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. J Autoimmune. 2012;38(2-3):J266–74.

    Article  CAS  Google Scholar 

  18. Angulo MA, Butler MG, Cataletto ME. Prader-Willi syndrome: a review of clinical, genetic, and endocrine findings. J Endocrinol Invest. 2015;38(12):1249–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Forni PE, Wray S. GnRH, anosmia and hypogonadotropic hypogonadism--where are we? Front Neuroendocrinol. 2015;36:165–77. doi:10.1016/j.yfrne.2014.09.004.

    Article  CAS  PubMed  Google Scholar 

  20. Fraietta R, Zylberstejn DS, Esteves SC. Hypogonadotropic hypogonadism revisited. Clinics (Sao Paulo). 2013;68 Suppl 1:81–8.

    Article  PubMed  Google Scholar 

  21. Rochira V, Guaraldi G. Hypogonadism in the HIV-infected man. Endocrinol Metab Clin North Am. 2014;43(3):709–30.

    Article  PubMed  Google Scholar 

  22. Gautier A, Lainé F, Massart C, Sandret L, Piguel X, Brissot P, Balkau B, Deugnier Y, Bonnet F. Liver iron overload is associated with elevated SHBG concentration and moderate hypogonadotropic hypogonadism in dysmetabolic men without genetic haemochromatosis. Eur J Endocrinol. 2011;165(2):339–43.

    Article  CAS  PubMed  Google Scholar 

  23. Sinclair M, Grossmann M, Gow PJ, Angus PW. Testosterone in men with advanced liver disease: abnormalities and implications. J Gastroenterol Hepatol. 2015;30(2):244–51.

    Article  PubMed  Google Scholar 

  24. Wu FC, Tajar A, Pye SR, Silman AJ, Finn JD, O’Neill TW, Bartfai G, Casanueva F, Forti G, Giwercman A, Huhtaniemi IT, Kula K, Punab M, Boonen S, Vanderschueren D, European Male Aging Study Group. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab. 2008;93(7):2737–45.

    Article  CAS  PubMed  Google Scholar 

  25. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta-analysis. JAMA. 2006;295(11):1288–99.

    Article  CAS  PubMed  Google Scholar 

  26. Aversa A, Morgentaler A. The practical management of testosterone deficiency in men. Nat Rev Urol. 2015;12(11):641–50. doi:10.1038/nrurol.2015.238.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vijaya Surampudi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Surampudi, V., Swerdloff, R.S. (2017). Hypogonadotropic and Hypergonadotropic Hypogonadism. In: Hohl, A. (eds) Testosterone. Springer, Cham. https://doi.org/10.1007/978-3-319-46086-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46086-4_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46084-0

  • Online ISBN: 978-3-319-46086-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics