Hypogonadism history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

The most common symptoms of hypogonadism in males include delayed puberty and loss of sexual characters as voice deepening and hair growth. Common symptoms include also erectile dysfunction, small testes, loss of libido and sweating. Common symptoms in females include no breast enlargement and no pubic hair. Less common symptoms include a headache, visual impairment, galactorrhea, and anorexia nervosa.

History and symptoms

History is important in the diagnosis of hypogonadism. The onset of the symptoms and previous congenital gonadal anomalies should be known.

For both males and females:
- History is important to know if there was any gonadal abnormality since birth or not. The onset of puberty should also be known.
- The family history of delay of growth and development increases the probability of gonadotropin hormones deficiency and hypogonadism.
For males:
- History of any causes of testicular failure as radiation to testes, chemotherapy or drugs decreasing testosterone secretion.
For females:
- Menstrual history is important and the date of menarche.
- History of increased androgen secretion as acne and hirsutism.

Common symptoms in males

Symptoms of hypogonadism depend on the onset of the disease whether before puberty or after. The common symptoms of hypogonadism in are listed in the following table:^[1]^[2]^[3]

Pre-pubertal	Post-pubertal (Adult)
Delayed puberty and loss of sexual characters: No beard Failure of voice deepening Small or absent testes No muscle mass gaining Micropenis Loss of smelling sense (In cases of Kallmann syndrome)	Decrease of libido Decreased erections Erectile dysfunction Decreased size of testes Sweating Breast enlargement Muscle loss and decreased bone density Infertility Loss of body hair

Common symptoms in female:

Delayed puberty and loss of the secondary sexual characteristics:
- No breast development
- No pubic hair

Less common symptoms

Headaches
Visual loss
Galactorrhea
Anorexia nervosa
Fatigue and weakness
Loss of energy
Depression
Sleeping disturbances
Decreased work performance

References

↑ Khera M, Broderick GA, Carson CC, Dobs AS, Faraday MM, Goldstein I; et al. (2016). “Adult-Onset Hypogonadism”. Mayo Clin Proc. 91 (7): 908–26. doi:10.1016/j.mayocp.2016.04.022. PMID 27343020.
↑ Basaria S (2014). “Male hypogonadism”. Lancet. 383 (9924): 1250–63. doi:10.1016/S0140-6736(13)61126-5. PMID 24119423.
↑ Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS; et al. (2010). “Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline”. J Clin Endocrinol Metab. 95 (6): 2536–59. doi:10.1210/jc.2009-2354. PMID 20525905.

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[pmid27343020-1] Khera M, Broderick GA, Carson CC, Dobs AS, Faraday MM, Goldstein I; et al. (2016). “Adult-Onset Hypogonadism”. Mayo Clin Proc. 91 (7): 908–26. doi:10.1016/j.mayocp.2016.04.022. PMID 27343020.

[pmid24119423-2] Basaria S (2014). “Male hypogonadism”. Lancet. 383 (9924): 1250–63. doi:10.1016/S0140-6736(13)61126-5. PMID 24119423.

[pmid20525905-3] Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS; et al. (2010). “Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline”. J Clin Endocrinol Metab. 95 (6): 2536–59. doi:10.1210/jc.2009-2354. PMID 20525905.

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