Risk Factors for and Causes of Male Hypogonadism

Posted by Dr. Michael White, Updated on April 25th, 2024
Reading Time: 5 minutes

581-6818766-xl-jpgMale Hypogonadism is a relatively common medical condition that afflicts men of all ages but is most common among men forty and over.

Symptomatic Testosterone Deficiency is believed to afflict 5% of men in America but becomes increasingly likely as men grow older.

It's estimated that around 6.5 million men across the United States struggle with Low-T. By age 70, almost 20% of men have significant symptoms directly attributable to declining Testosterone Levels.

Types of Hypogonadism: Primary and Secondary Hypogonadism

Primary Hypogonadism

Primary Hypogonadism is any form of Testosterone Deficiency that results in a direct inability of the testes to adequately produce Testosterone.

Primary Hypogonadism is often the result of genetic conditions such as Klinefelter's syndrome, which is the result of boys conceived with two X chromosomes.

In adults, Primary Hypogonadism is generally the result of conditions that directly impact or damage the testes, such as cancer, radiation treatments, surgery, and physical trauma.

There are also many medications that can suppress testicular activity, such as neoplastic agents (including busulfan, cyclophosphamide, cisplatin, and chlorambucil), ketoconazole, and glucocorticoids.

Secondary Hypogonadism

Secondary Hypogonadism is the most common form of Testosterone Deficiency. Rather than being a deficiency directly related to impaired testicular function, Secondary Hypogonadism is the result of impaired upstream signaling, resulting primarily from diminished or non-production of Gonadotropin-Releasing Hormone (GnRH).

In many cases, Low Testosterone Levels are paired with low levels of Follicle-Stimulating Hormone and Luteinizing Hormone in the case of Secondary Hypogonadism.

While Secondary Hypogonadism can be the result of congenital issues, this is quite rare. In children and adults, many medications can impair Testosterone Production via the suppression of Testosterone Secretagogues, including opiates, glucocorticoids, and steroids.

The most-experienced form of Secondary Hypogonadism is Andropause, also known as Age-Related Testosterone Deficiency. As men grow older, their ability to produce Testosterone naturally diminishes slowly over time, a direct result of reduced upstream signaling to the testes and adrenal glands for Testosterone Production.

Symptoms of Hypogonadism in Men

Because Testosterone is the primary source of physiological masculinity, Testosterone Deficiency has widespread effects on form and function.

The most well-known aspects of Hypogonadism are low libido and sexual dysfunction, but Low-T causes far more significant and broader issues. Testosterone promotes healthy body composition, and when Testosterone Levels fall too far, it leads to both increased body fat and reduced muscle mass. Psychologically, hypogonadism is strongly associated with depression, anxiety, and trouble sleeping.

Testosterone also has a substantial protective effect on the heart, and Hypogonadism has a dangerous correlation with a heart attack and heart disease. Significant Hypogonadism can lead to fertility issues, anemia, auxiliary hair loss, and more.

The symptoms of Hypogonadism are also strongly associated with age-of-onset. Children suffering from Hypogonadism experience delayed the onset of puberty, femininization, and other significant symptoms resulting from the developmental influence of Testosterone during adolescence.

These symptoms can be relieved via Testosterone Replacement Therapy. Prenatal Testosterone Deficiency is generally the result of genetic defects and can have extreme developmental consequences.

Obesity, Bodyfat, and Hypogonadism

A primary risk factor for Testosterone Deficiency and Low-T is Obesity. Adipose fat cells, which congregate around the hips and midsection, have a nasty side-effect of converting Testosterone into Estrogen.

In healthy body composition, there is a balance that strongly favors normal Testosterone Levels. The more that you weigh, however, the stronger of an influence that body fat has upon your Serum Testosterone.

If you are overweight or obese, one of the best things that you can do to improve your Testosterone Balance is to lose weight.

Diabetes and Hypogonadism

Diabetes is a chronic medical condition that has a significant impact on Testosterone Levels. Just being overweight or obese increases the risk of Low-T, but the threats compound with Diabetes.

Studies have shown that around 1/3rd of patients that are simultaneously obese and suffering from Type-2 Diabetes struggle with significant Testosterone Deficiency.

If you are experiencing diabetes and are overweight, losing weight can help increase Testosterone Levels, but it still appears that Type-2 Diabetes has a negative influence on Testosterone Levels at any bodyweight.

Recent studies have shown that Bio-Identical Testosterone may have a positive impact on wellness and health among Type-2 Diabetes Patients.

Alcohol and Hypogonadism

Drinking has a negative impact on Testosterone Production and contributes to Hypogonadism. Drinking too much alcohol suppresses the function of the testes, which leads not only to suppressed Testosterone Production but also diminished fertility and sperm count.

Alcoholism can even directly damage testicular tissue. It's a common issue among heavy drinkers to have an impaired libido. If you are a moderate to heavy drinker and have been having problems with erectile dysfunction and low libido, cutting back on alcohol may have a miraculous effect on your sexual function.

Sedentary Lifestyle and Testosterone Deficiency

Testosterone is produced mainly as a consequence of physical activity. Your body responds to physical exertion of the muscles by elevating Testosterone Production. Exercises that work out large groups of muscles have been shown to provide a burst of Testosterone.

On the other hand, this means that an inactive lifestyle has a tremendously negative impact on Testosterone Levels. Sadly, this phenomenon feeds upon itself.

If you aren't up and moving, your body isn't making Testosterone. If your body doesn't produce enough Testosterone, then you'll have significant issues with fatigue and diminished exercise capacity.

The best way to combat this cause of Hypogonadism is to force yourself to get up and to move by any means necessary. Start slow, and you'll find yourself energized and happier in no time!

Stress and Testosterone Deficiency

One of the primary factors of hormone imbalance is stress.

The human body ultimately has a maximum reserve of hormones that it can produce.

Many of these hormones are highly beneficial to preserving your long-term health, including Testosterone and Human Growth Hormone. Others deliver benefits in the short term, like Endorphins and Cortisol. Cortisol is the body's primary response to stress.

It prepares the human body for fight-or-flight. It sets you up for snap decisions and decisive action. The problem with Cortisol is when you produce too much of it too frequently.

Physical and psychological stress are intrinsically linked, and too much of either for too long will have a negative impact on your long-term hormone balance.

If you live a lifestyle that's high in stress, or you have issues with stress management, then taking steps to improve your stress levels will have a positive impact on your hormone balance.

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