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What is it about ?
The organs that produce sex hormones are the testes in men and the ovaries in women. With a deficiency of male hormones in men, the testes do not produce enough testosterone (male hypogonadism).
A distinction is made between primary hypogonadism and secondary hypogonadism.
In case of’primary hypogonadism, the problem lies in the testes themselves, for example:
- undescended testicle;
- inflammation;
- irradiation;
- influence of certain drugs on the testicle;
- Klinefelter syndrome, congenital.
In case of’secondary hypogonadism, the problem is in the brain, which no longer sends signals to the testes to produce testosterone. Secondary hypogonadism can be congenital or have another cause:
- brain tumour ;
- irradiation;
- brain trauma;
- undernutrition;
- anorexia nervosa.
There is a third form, thelate hypogonadism, also called andropause. This phenomenon can affect an aging man, as the function of the testes deteriorates with age.
Only a small number of men develop true hypogonadism, as the decline in testicular function in most men is offset by increased stimulation from the brain.
How to recognize it?
If hypogonadism begins before puberty, it can have the following consequences:
- stunted growth;
- long limbs;
- acute voice ;
- poor muscle development;
- immature genitals;
- delayed puberty.
If it occurs later in life, hypogonadism can lead to:
- decreased libido;
- impotence;
- a change in male sexual characteristics, such as body hair and voice.
It can also cause fatigue, anemia, and depression.
Klinefelter syndrome is a congenital genetic defect that affects men and is caused by the presence of one or more additional X sex chromosomes (for example XXY or XXXY instead of XY). It is characterized by:
- small testicles;
- long limbs;
- delayed puberty;
- sometimes a slightly deficient intelligence;
- a predisposition to diabetes and certain diseases of the lungs.
How is the diagnosis made?
First, the doctor takes a blood sample to measure the level of testosterone and other sex hormones. This blood test takes place preferably in the morning. It is not easy to diagnose hypogonadism. First, because testosterone levels fluctuate even in healthy men. In addition, testosterone levels may decrease during excessive physical exercise (intensive sport), fasting, stress or depression.
If the testosterone level is indeed low, the doctor may diagnose hypogonadism. He must then determine whether it is primary hypogonadism or secondary hypogonadism. Sometimes genetic testing (for the diagnosis of Klinefelter syndrome) or brain imaging (such as an MRI) is indicated.
What can you do ?
In boys, the characteristics of puberty should be visible no later than the age of 14 years. If not, it is better to consult a doctor. If you yourself have any of the above symptoms, see a doctor. There is nothing you can do to increase the testosterone levels in your body on your own.
What can the doctor do?
In order to remedy the male hormone deficiency, testosterone can be administered by injection into the muscle (with an interval of several weeks between two injections) or by means of a gel on the skin (to be applied every day) . In case of secondary hypogonadism, the cause of the testosterone deficiency should also be treated.
A man cannot be given testosterone in the following cases:
- Prostate cancer ;
- enlargement (enlargement) of the untreated prostate;
- breast cancer ;
- severe sleep apnea;
- severe heart failure;
- polycythemia (blood disease characterized by an excess of red blood cells).
In older men, who often have prostate problems, care should therefore be taken when administering testosterone. Other causes, such as being overweight, need to be addressed first. A test treatment with testosterone can only be started in the case of severe symptoms (reduced libido, impotence, absence of erection in the morning). In the event of a positive result, the treatment will be continued.
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