Hypogonadism can develop for a variety of reasons and is typically categorized as either:
Primary Hypogonadism: This occurs when the problem originates in the testes, which are unable to produce sufficient testosterone despite normal signaling from the brain.
Secondary Hypogonadism: This form results from issues in the pituitary gland or hypothalamus, the parts of the brain responsible for signaling the testes to produce testosterone.
Both types lead to low testosterone levels, but the underlying causes can be very different. Common contributors include:
Genetic Conditions (such as Klinefelter Syndrome): Some men are born with genetic abnormalities that impair testicular development and function, making them more prone to testosterone deficiency.
Injuries or Infections Affecting the Testes: Trauma, surgery, radiation, chemotherapy, or infections such as mumps orchitis can damage the testes and reduce their ability to produce hormones.
Chronic Illnesses: Conditions like type 2 diabetes, obesity, liver disease, kidney disease, or HIV/AIDS can interfere with hormone production and regulation, increasing the risk of hypogonadism.
Hormonal Disorders or Pituitary Gland Dysfunction: Tumors, inflammation, or injury affecting the pituitary gland or hypothalamus may reduce or block the signals needed to stimulate testosterone production.
Certain Medications: Long-term use of opioids, corticosteroids, anabolic steroids, or some cancer treatments can suppress testosterone production and disrupt hormonal balance.
In some cases, hypogonadism develops from a combination of lifestyle, medical, and genetic factors. Identifying whether the condition is primary or secondary is essential, as it helps guide treatment—whether that means directly replacing testosterone or addressing the underlying signaling issue.