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Reporter and Curator: Dr. Sudipta Saha, Ph.D.

 

Hypogonadotropic hypogonadism is a form of hypogonadism that is due to a problem with the pituitary gland or hypothalamus. In this condition, the male testes or the female ovaries produce little or no hormones.

 

Causes:

Hypogonadotropic hypogonadism is caused by a lack of secretion of the gonadal stimulating pituitary hormones: follicle stimulating hormone (FSH) and luteinizing hormone (LH). Normally, the hypothalamus in the brain releases gonadotropin-releasing hormone (GnRH). This hormone stimulates the pituitary gland to release other hormones, including FSH and LH. These hormones tell the female ovaries and male testes to release hormones that lead to normal sexual development in puberty. Any change in this hormone release chain causes a lack of sex hormones and prevents normal sexual maturity. Failure of the hypothalamus is usually a result of Kallmann syndrome. Kallmann syndrome is an inherited form of hypogonadotropic hypogonadism that can occur with a loss of smell.

Symptoms:

  • Erectile dysfunction in men
  • Inability to smell (in some cases)
  • Lack of development at puberty (development may be incomplete or delayed)
  • Lack of secondary sexual characteristics such as pubic, facial, and underarm hair
  • Loss of menstrual periods in women
  • Short stature (in some cases)
  • Underdeveloped testicles

 

Treatment:

Treatment depends on the source of the problem, but may involve:

  • Estrogen and progesterone pills
  • GnRH injections
  • Injections of testosterone
  • Slow-release testosterone skin patch
  • Surgery to remove a pituitary tumor
  • Testosterone gels

 

Expectations (prognosis):

With the right hormone treatment, the person can go through puberty and fertility may be restored.

 

Complications:

  • Delayed puberty
  • Infertility
  • Low self-esteem due to late start of puberty (emotional support may be helpful)
  • Sexual dysfunction

 

Prevention:

Prevention depends on the cause. People who have a family history of inherited conditions that cause hypogonadism may benefit from genetic counseling. Preventing serious head injuries reduces the risk of hypogonadotropic hypogonadism due to pituitary injury.

 

Source References:

 

http://www.umm.edu/ency/article/000390.htm

 

http://health.nytimes.com/health/guides/disease/hypogonadotropic-hypogonadism/overview.html

 

http://www.ncbi.nlm.nih.gov/books/NBK1278/

 

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