Hypogonadism: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Hypogonadism?
An endocrinologist, a doctor who treats hormone problems, usually treats hypogonadism. Some people also see a urologist, a doctor for the male reproductive system. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is hypogonadism?
Hypogonadism occurs when the body's sex glands (gonads) make little or no hormones. In men, these glands are the testes. In women, these glands are the ovaries.
It can be primary or central. In primary hypogonadism, the ovaries or testes do not work as they should. In central hypogonadism, the parts of the brain that control the gonads do not work well. These parts are the hypothalamus and the pituitary.
Symptoms
Symptoms depend on whether it starts before or after puberty. Girls who have hypogonadism will not start having periods. It can affect their breast development and height.
If it starts after puberty, symptoms in women include:
- Hot flashes.
- Energy and mood changes.
- Periods that become irregular or stop.
In boys, hypogonadism affects muscle, beard, genital and voice development. It also leads to growth problems. In men, symptoms may include:
- Breast enlargement.
- Muscle loss.
- Low interest in sex.
- Infertility, or trouble having children.
- Loss of armpit and pubic hair.
A tumor in the brain or pituitary can cause headaches or vision loss. It can also cause milky breast discharge or signs of other low hormones.
Causes and who gets it
Primary hypogonadism has several causes. These include some autoimmune disorders, infection, radiation, surgery and injury. The most common inherited causes are Turner syndrome in women and Klinefelter syndrome in men.
Causes of central hypogonadism include:
- Anorexia nervosa.
- Medicines such as glucocorticoids and opiates.
- Rapid, significant weight loss.
- Tumors, trauma, and radiation or surgery near the pituitary.
A genetic cause of central hypogonadism is Kallmann syndrome.
Menopause is the most common reason for hypogonadism. It is normal in all women and happens on average around age 50.
Testosterone levels also decrease in men as they age. In men, causes also include mumps, injury to the testicles, obesity and cystic fibrosis. Heavy marijuana use and undescended testicles at birth can raise the risk.
How doctors diagnose it
You may need tests to check hormone levels. These check estrogen in women and testosterone in men. They also check two hormones, FSH and LH. Test results can be hard to read in older men and in men who are obese.
Other tests may include a prolactin level, thyroid tests and a sperm count. Doctors may also do gene tests. A scan of the ovaries may be used. If pituitary disease is suspected, an MRI or CT scan of the brain may be done.
Treatment
You may need hormone-based medicines. Estrogen and progesterone are used for girls and women. Testosterone is used for boys and men. It can be given as a skin patch, skin gel or injection.
In some women, injections or pills can help stimulate ovulation. Injections of pituitary hormone may help men produce sperm. Some people need surgery and radiation if the cause is in the pituitary or hypothalamus.
Men who take testosterone need close checks by their provider. It may cause a larger prostate, blood clots, sleep and mood changes, or blood that gets too thick. Long-term hormone use in women may raise the risk of breast cancer, blood clots and heart disease.
Many forms can be treated and have a good outlook. In men, many forms cannot be reversed. Testosterone can help reverse symptoms.
When to see a doctor
Contact your provider if you notice breast discharge or hot flashes. Also call about a lost period or trouble getting pregnant. Also tell your provider about body hair loss, a low sex drive or weakness.
Both men and women should contact their provider if they have headaches or vision problems. If you take testosterone and think it is causing side effects, contact your provider.
Call 911 or go to the emergency room if you faint, have chest pain for two minutes or more, have trouble breathing, or have a sudden change in vision or sudden weakness.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review your symptoms and order first blood tests. They can also help you keep up with endocrinologist visits and follow-up care.
Common questions
What is the difference between primary and central hypogonadism?
In primary hypogonadism, the problem is in the testes or ovaries. In central hypogonadism, the problem is in the parts of the brain that control the gonads.
Is menopause a form of hypogonadism?
Yes, menopause is a natural form of hypogonadism. It can cause hot flashes, vaginal dryness and irritability as estrogen levels fall.
Can men with hypogonadism still have children?
It depends. Testosterone treatment may not restore fertility. Injections of pituitary hormone may help men produce sperm. Men having chemotherapy that can cause hypogonadism should talk about freezing sperm first.
Can hypogonadism be prevented?
Sometimes. Staying fit, keeping a normal weight and eating healthy may help in some cases. Other causes may not be preventable.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
