What is Hypogonadism?

What is Hypogonadism and can it occur in children as well as adults?

Hypogonadism can occur in men and women but it more common in men. It can also occur in children.

Hypogonadism is a hormonal disorder. It happens when the ovaries or testes (gonads) do not produce enough progesterone, estrogen, and testosterone. These are called gonadal hormones. Without enough hormones the ovaries or testes shrink and fail to produce enough ova or sperm (germ cells). Hypogonadism also affects other areas of the body, like the growth of the brain, bones and muscles. Fat, body hair, and breasts are also affected.
People with hypogonadism can have:
Memory and concentration problems (“brain fog”)
Thin, brittle bones that break easily
Abnormal hair and muscle growth
Low sex drive (libido)
Sexual dysfunction including a dry, degenerated vagina, impotence, or erectile dysfunction
Heart and blood vessel disease
Infertility

Gonadal hormones are controlled by the pituitary gland in the brain. These hormones play many roles: they determine the sex of a fetus and decides when a child reaches maturity. They also determine the reproductive functions. There are twho types of hypogonadism: primary and secondary. Problems with the ovaries or testes result in primary hypogonadism. Problems with the pituitary gland result in Secondary hypogonadism.
While this article covers information on hypogonadism in both adults and children, more specific information pertaining to childhood hypogonadism can be found here:

When does hypogonadism occur?
Hypogonadism can develop at any age.

If a fetus has hypogonadism, it is sexually ambiguous and then genitals may not appear clearly male or female (hermaphrodite).

When a child develops hypogonadism, then he or she may not enter puberty. If a young person develops hypogonadism, then he or she will be infertile and may be sexually dysfunctional.

In women, normal hypogonadism happens during menopause, around age 51, when women’s production of estrogen and progesterone decreases as the childbearing years end. Many young women are in early menopause because of hysterectomy, kidney failure, cancer treatment, or ovarian failure.

Men can develop androgen deficiency (andropause, male menopause, or late-onset hypogonadism) after age 50 and often earlier.

Who develops hypogonadism?

Hypogonadism in children

First, a little background: The default sex of an embryo is female. Girls are made with two X chromosomes (XX). Boys are made with an X and a Y chromosome (XY). If a male sperm fertilizes an egg, then the baby will be male. However, if the sex chromosomes are damaged or the androgen hormones are inadequate to stimulate male development, then the child will be sexually ambiguous.

XXY syndrome (Klinefelter Syndrome) is the major cause of primary hypogonadism in males, which occurs in 1 out of every 500 male births in the USA. It is a chromosomal abnormality that occurs in boys only. It’s when they have one extra X chromosome.

XYY syndrome is another cause of hypogonadism, which occurs in one out of every 1,000 live births. This is also a chromosomal abnormality that affects boys only. They are born with an extra Y chromosome.

Both male and female children can develop hypogonadism because of Kallman’s syndrome (KS). One in 10,000 males has KS. One in 50,000 females has KS.

Turner’s syndrome causes hypogonadism in one out of every 250,000 live births. This chromosomal abnormality means that one X chromosome is missing. It can only happen to girls. 20% of miscarriages in the first trimester happen because of Turner’s syndrome. The rate of miscarriages in women who have Turner’s syndrome stands at 98%.
Hypogonadism in Adults

In women, menopause is hypogonadism because of normal female ageing. There are about 25 million women in the menopause transition worldwide at any one time. By 2030, about 1.2 billion women will have experienced menopause.
Between 20% & 30% of males older than 46 are androgen deficient, showing symptoms consistent with androgen deficiency yet recent medical research shows most remain untreated.

What causes hypogonadism?
Hypogonadism is caused by:
Stress
Trauma
Anorexia
Radiation or Chemotherapy
Sickle cell anemia
Environmental toxins
Viral orchitis caused by mumps after puberty
Too much prolactin, the milk-producing hormone
Genetic disorders (Turner’s syndrome or XYY or XXY syndrome)
Disruption of complex female hormone cycling
Illegal drug abuse
Prescription drugs (eg. methadone, spironolactone, and ketokonazole)
Liver and kidney disease
Gonadal cancer
Removal of the pituitary gland to treat a pituitary tumor, or breast or
prostate cancer
Diabetes
Malnutrition
Cushing syndrome
Hemochromatosis
Alstrom syndrome
Laurence-Moon Biedl syndrome
NOTE: This list does not include all causes.

Understand more on Hypogonadism:

What are the symptoms of hypogonadism?

What are the best treatment options for Hypogonadism?

The information in this article has been taken with permission from the official Lawley booklet on Understanding Hypogonadism.