Low Sex Drive (Hypogonadism)
What is hypogonadism?
Hypogonadism occurs when sex glands called gonads produce little, if any, sex hormones. It affects teenagers and adults of all genders. The condition causes a low sex drive or libido. Hypogonadism is sometimes called gonad deficiency.
What are the sex glands and sex hormones?
Testicles (testes) in the male reproductive system produce testosterone, the main male hormone. Hypogonadism in men is the result of low testosterone.
Ovaries in the female reproductive system produce estrogen, progesterone and testosterone. Women with hypogonadism are often low in estrogen and progesterone.
What are the types of hypogonadism?
Two glands in your brain, the hypothalamus and pituitary, send signals to sex glands. These signals tell your body to make sex hormones. When you have hypogonadism, something within the brain or sex glands interferes with hormone production.
Healthcare providers look at the cause to determine if hypogonadism is:
- Primary hypogonadism: A problem within the sex glands slows or stops hormone production.
- Secondary (central) hypogonadism: A problem with brain signals affects hormone production.
Who might have hypogonadism?
Starting in their late 40s or 50s, everyone has lower amounts of sex hormones. As a result, sex drives decrease. These changes are expected. They aren’t necessarily a sign of hypogonadism. Younger people who have little to no interest in sex may have hypogonadism.
Conditions and treatments that raise the risk of primary hypogonadism include:
- Endocrine (adrenal gland) disorders, such as diabetes or Addison’s disease.
- Cancer treatments, including radiation therapy and chemotherapy.
- Genetic disorders, such as Turner syndrome (in females) or Klinefelter syndrome (in males).
- Excess iron (hemochromatosis).
- Undescended testicles.
- Liver disease or kidney disease.
- Surgery on reproductive organs.
Risk factors for secondary hypogonadism include:
- Anabolic steroids or opioid use.
- Brain surgery.
- Cancer treatments.
- Genetic disorders that affect brain development, such as Prader-Willi syndrome.
- Infections, including HIV.
- Inflammatory diseases, such as sarcoidosis.
- Obesity.
- Pituitary tumors (adenomas) and disorders.
What causes hypogonadism?
It isn’t clear why some people develop hypogonadism. For unknown reasons, a problem with the sex glands or brain affects the body’s production of sex hormones.
What are the symptoms of hypogonadism?
Hypogonadism symptoms vary depending on the cause and a person’s gender. Teenagers may get a diagnosis of secondary hypogonadism when they don’t start puberty on time. For example, teen girls with hypogonadism may not get their periods or develop breasts. Boys might not grow facial hair or have underdeveloped testicles.
Adults may experience a low sex drive (sexual dysfunction), as well as hair loss and hot flashes. Other common complaints include fatigue and difficulty concentrating.
Signs of hypogonadism in females include:
Signs of hypogonadism in males include:
- Enlarged breasts (gynecomastia).
- Erectile dysfunction.
- Infertility due to low sperm count.
- Muscle loss.
