Hypogonadism
A condition in which the ovaries or testes make too little of their sex hormones — estrogen in women, testosterone in men. It causes symptoms such as low libido, fatigue, infertility, and in women irregular or absent periods, and can arise from the gonads themselves or from the pituitary gland that controls them.
What it is
Hypogonadism means the sex glands (gonads) — the ovaries in women and the testes in men — are producing too little of their sex hormones. It is understood through the axis that controls them: the pituitary gland in the brain releases the hormones FSH and LH, which tell the gonads to make estrogen and progesterone (women) or testosterone (men) and to produce eggs or sperm. Hypogonadism is divided by where the problem lies. In primary hypogonadism, the gonads themselves fail: sex hormones fall, and the pituitary responds by pushing FSH and LH up high — as in ovarian failure, testicular damage, or genetic conditions. In secondary (central) hypogonadism, the pituitary or hypothalamus is at fault: it fails to send enough FSH and LH, so the gonads are not stimulated and sex hormones fall together with low or inappropriately normal FSH and LH — as with pituitary problems, certain drugs, or severe stress and illness. This FSH/LH pattern is how the two are told apart. Symptoms depend on sex and timing: in adults, low libido, fatigue, infertility, and in women irregular or absent periods and menopausal-type symptoms; in men, reduced muscle, erectile difficulty and low mood. If it occurs before puberty, it delays sexual development. Diagnosis rests on measuring the sex hormones together with FSH and LH.
Key lab markers
- Testosterone (men) / estradiol (women) — the sex hormones; low in hypogonadism.
- FSH and LH — the key to classifying it: HIGH FSH/LH with low sex hormones means primary (gonadal) failure; LOW or inappropriately normal FSH/LH means a secondary (pituitary/hypothalamic) cause.
- Prolactin — a high level can suppress the axis and cause secondary hypogonadism.
- Other pituitary hormones (e.g. TSH) — assessed if a pituitary cause is suspected.
- Inhibin B / AMH — sometimes used to assess gonadal (ovarian or testicular) function.
Symptoms
- Low sex drive (libido)
- Fatigue and low energy
- Infertility or difficulty conceiving
- In women: irregular or absent periods, hot flushes, vaginal dryness
- In men: erectile difficulty, reduced muscle mass, loss of body hair
- Low mood
- Reduced bone density over time (increased fracture risk)
- If before puberty: delayed or absent sexual development
Related symptoms
Related lab panels
When to discuss with a doctor
See a doctor for symptoms suggesting low sex hormones — persistent low libido and fatigue, difficulty conceiving, or, in women, periods that become irregular or stop (outside pregnancy and the expected age of menopause), and in men reduced muscle, erectile difficulty and low mood. Delayed puberty in a teenager also warrants assessment. Because hypogonadism can arise from the gonads or the pituitary, and because a high prolactin or a pituitary problem needs its own work-up, the pattern of sex hormones together with FSH, LH and prolactin guides the cause and treatment. Untreated, low sex hormones also affect bone strength over time. Mediora.AI can surface the low-hormone pattern together with FSH and LH that distinguishes a primary from a secondary cause, prompting the right next tests, but diagnosis and treatment belong with your doctor or endocrinologist.