Hypogonadotropic hypogonadism

Definition[edit | edit source]

Abnormal ovarian function or testicular function due to insufficient hormonal stimulation from the hypothalamic-pituitary axis.

Location of hypothalamus, pituitary gland and olfactory bulb.

Causes[edit | edit source]

Hypogonadotropic hypogonadism is due to lack of the pituitary stimulating hormones such as gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH).

List of causes:

Damage to the pituitary gland or hypothalamus from surgery, injury, tumor, infection, or radiation
Genetic defects
High doses or long-term use of opioid or steroid (glucocorticoid) medicines
High prolactin level (a hormone released by the pituitary)
Severe stress
Nutritional problems (both rapid weight gain or weight loss)
Long-term (chronic) medical diseases, including chronic inflammation or infections
Drug use, such as heroin or use or abuse of prescription opiate medicines
Certain medical conditions, such as iron overload
Kallmann syndrome is an inherited form of HH. Some people with this condition also have anosmia (loss of the sense of smell).

The genetic and molecular basis of idiopathic hypogonadotropic hypogonadism

Symptoms[edit | edit source]

Children:

Lack of development at puberty
In girls, a lack of breast development and menstrual periods
In boys, no development of sex characteristics, such as enlargement of the testes and penis, deepening of the voice, and facial hair
Inability to smell called anosmia
Short stature

Report on the XYY chromosomal abnormality

Adults:

Loss of libido in men
Amenorrhea in women
Decreased energy and interest in activities
Loss of muscle mass in men
Weight gain
Mood changes
Infertility

Exams and Tests[edit | edit source]

The health care provider will perform a physical exam and ask about your symptoms.

Tests that may be done include:

Blood tests to measure hormone levels such as FSH, LH, and TSH, prolactin, testosterone and estradiol

LH response to GnRH
MRI of the pituitary gland/hypothalamus (to look for a tumor or other growth)
Genetic testing
Blood tests to check for iron level

Treatment[edit | edit source]

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

Males

Injections of testosterone
Slow-release testosterone skin patch
Testosterone gels

Females

Estrogen and progesterone pills or skin patches (in females)
GnRH injections
HCG injections

The right hormone treatment will cause puberty to start in children and may restore fertility in adults. If the condition begins after puberty or in adulthood, symptoms will often improve with treatment.

Possible Complications[edit | edit source]

Health problems that may result from HH include:

Delayed puberty
Early menopause (in females)
Infertility
Low bone density and fractures later in life
Low self-esteem due to late start of puberty (emotional support may be helpful)
Sexual problems, such as low libido

ICD[edit | edit source]

N91.1

Hypogonadotropic hypogonadism Resources
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