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Hypogonadotropic hypogonadism

Gonadotropin deficiency; Secondary hypogonadism

Hypogonadism is a condition in which the male testes or the female ovaries produce little or no sex hormones.

Hypogonadotropic hypogonadism (HH) is a form of hypogonadism that is due to a problem with the pituitary gland or hypothalamus.

Images

Endocrine glands
The pituitary gland
Gonadotropins

Causes

HH is caused by a lack of hormones that normally stimulate the ovaries or testes. These hormones include gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH) and luteinizing hormone (LH).

Normally:

There are several causes of HH:

Kallmann syndrome is an inherited form of HH. Some people with this condition also have anosmia (loss of the sense of smell).

Symptoms

Children:

Adults:

Exams and Tests

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

Tests that may be done include:

Treatment

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

Outlook (Prognosis)

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

Health problems that may result from HH include:

When to Contact a Medical Professional

Call your provider if:

Related Information

Testes
Follicle-stimulating hormone (FSH) blood test
Luteinizing hormone (LH) blood test
Empty sella syndrome
Pituitary tumor
Head injury - first aid
Infertility

References

Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Physiology and disorders of puberty. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 25.

White PC. Sexual development and identity. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 220.

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Review Date: 7/16/2019  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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