Hypogonadotrophic hypogonadism
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Secondary hypoganadism; Central hypogonadism; gonadotropin-releasing hormone deficiency; gonadotropin deficiency
Overview
Hypogonadotropic hypogonadism is a condition which is characterized by hypogonadism due to an impaired secretion of gonadotropins, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH), by the pituitary gland in the brain, and in turn decreased gonadotropin levels and a resultant lack of sex steroid production.[1]
Causes
The type of HH, based on its cause, may be classified as either primary or secondary.
- Primary HH, also called isolated HH, is responsible for only a small subset of cases of HH, and is characterized by an otherwise normal function and anatomy of the hypothalamus and anterior pituitary. It is caused by congenital syndromes such as Kallmann syndrome and gonadotropin-releasing hormone (GnRH) insensitivity.
- Secondary HH, also known as acquired or syndromic HH, is far more common than primary HH, and is responsible for most cases of the condition. It has a multitude of different causes, including brain or pituitary tumors, pituitary apoplexy, head trauma, ingestion of certain drugs, and certain systemic diseases and syndromes.[1]
Diagnosis
History and Symptoms
Examples of symptoms of hypogonadism include delayed, reduced, or absent puberty, low libido, and infertility.
Treatment
Treatment of HH may consist of administration of either a GnRH agonist or a gonadotropin formulation in the case of primary HH and treatment of the root cause (e.g., a tumor) of the symptoms in the case of secondary HH. Alternatively, hormone replacement therapy with androgens and estrogens in males and females, respectively, may be employed.
See also
- Hypogonadism
- Delayed puberty and infertility
- Hypothalamus, pituitary gland, and HPG axis
- Gonads (testicles and ovaries)
- GnRH and gonadotropins (FSH and LH)
- Sex hormones (androgens and estrogens)