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Disorders of Gonads - Hypogonadism and Hypergonadism

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The testes in the male and the ovaries in the female are the gonads or primary reproductive organs. Read the article to know more.

Medically reviewed by

Dr. Raveendran S R

Published At June 9, 2022
Reviewed AtFebruary 27, 2024

Introduction:

Gonadal disorders are medical conditions that affect the gonads. Infertility, sexual dysfunction, and low hormonal levels are all possible effects of gonadal disorders, among which hormonal imbalances are frequently linked to gonadal diseases. In addition, underlying medical issues, particular drugs, or genetic diseases can contribute to these effects. The physical, pathological, and genetic conditions that cause hypogonadism or hypergonadism are discussed below.

What Is Meant by Gonadal Dysfunction?

Gonadal dysfunction is the term that includes genetic disorders that affect the reproductive organs. Gonadal dysfunction can cause many effects on the external and internal organs.

What Is Hypogonadism, and What Are the Conditions That Induce It?

Hypogonadism is a disorder in which the body produces insufficient sex hormones. Turner syndrome in women and Klinefelter syndrome in men are the most frequent genetic disorders that cause primary hypogonadism. Certain inflammatory disorders that affect the hypothalamus and pituitary gland, including sarcoidosis, histiocytosis, and tuberculosis, can cause hypogonadism by affecting testosterone production.

What Is Hypergonadism, and What Are the Conditions That Induce It?

Hypergonadism is a disorder in which the body produces too much hormone. Hypergonadism is uncommon in comparison to hypogonadism. Hypergonadism is caused by Addison's disease, tumors, and infections.

What Are the Types of Hypogonadism?

There are three types of hypogonadism, namely:

  • Primary: It affects the main gonad, testes in males, and ovaries in females.

  • Secondary: In secondary hypogonadism, the hormonal imbalance is caused by dysfunction of the pituitary-hypothalamus axis.

  • Target Organ Resistance: The hormonal imbalance is due to receptor defects.

What Are the Causes of Hypogonadism?

The leading causes of hypogonadism are:

  • Chromosomal abnormalities such as Turner syndrome (one of the X chromosomes is absent or partially missing in the females) and Klinefelter syndrome (the male has an extra chromosome).

  • Mutations in the FSH (follicle-stimulating hormone) and LH (luteinizing hormone) genes.

  • Infections such as mumps (a condition which is caused by a virus) and orchitis (the inflammation that occurs in the testicles).

  • Radiotherapy and Chemotherapy.

  • Trauma.

  • Chronic conditions like cirrhosis of the liver.

  • Isolated hypogonadotropic hypogonadism.

What Are the Clinical Symptoms of Hypogonadism?

  • Reduced libido (sex drive).

  • Decreased number of sexual interactions.

  • Decreased muscle strength.

  • Poor arousal.

  • Loss of nocturnal erections.

  • Reduced quality of orgasms.

  • Reduced volume of ejaculate.

  • Increased irritability.

  • Hot flushes and sweating.

  • Depression and low self-esteem.

  • Insomnia.

  • Loss of body hair.

  • Gynecomastia (overgrowth of breast tissue in males).

What Are the Possible Complications of Hypogonadism?

Low hormone levels can affect overall health. Hypogonadism can lead to the following:

  • Metabolic Syndrome: Male hypogonadism is frequently connected to a metabolic syndrome that causes obesity, insulin resistance, dyslipidemia, and hypertension.

  • Hypertension: The effects of testosterone on the arteries are mixed. Many scientists believe testosterone plays a role in the increased prevalence of heart disease and high blood pressure.

  • Diabetes Mellitus: Hypogonadism and diabetes are directly proportional. The presence of one is likely to raise the likelihood of the other. Hypogonadism is not always linked to diabetes, but may be linked to vascular factors, medications, cigarettes, alcohol, and systemic disorders like hypertension, heart disease, and dyslipidemia can all contribute to testosterone shortage.

  • Inflammation: The hormones are thought to have anti-inflammatory properties. There is a drop in hormone levels in hypogonadism, resulting in a reduced anti-inflammatory action.

  • Atherosclerosis: Hypogonadism also plays a role in the development of atherosclerosis by raising inflammation and altering endothelial function and various other cellular pathways implicated in the disease's etiology.

  • Insulin Resistance: According to evidence-based studies, low hormone levels are linked to increased insulin resistance. Hormone replacement treatment can help to overcome this.

  • Vascular stiffness, obesity, and osteoporosis are also linked with low hormone levels.

How Is Hypogonadism Treated?

The treatment mainly involves addressing the cause of etiology and hormone replacement therapy. The following are the treatment modalities:

Pituitary secretion of gonadotropin can be conditioned by the administration of:

  • Corticosteroids.

  • Estrogen.

  • Progesterone.

  • Medications that increase the prolactin level.

Hormone replacement therapy includes using:

  • Transdermal patches.

  • Pellets and buccal hormonal tablets.

  • Intramuscular injections.

What Are the Causes of Hypergonadism?

Hypergonadism is a condition where the gonads produce too much of hormones. In the case of hypergonadism, the person may produce too much that is more than normal testosterone or estrogen. Often, the root issue of hypergonadism is never identified. A variety of medical problems can cause hypergonadism, which includes the following:

  • Ovaries or testes tumors (benign or malignant).

  • Liver or renal illnesses.

  • Some autoimmune illnesses, such as Hashimoto's thyroiditis (a condition that does not allow the thyroid gland to produce enough thyroid hormones) and Addison's disease (a condition that occurs when the body does not make enough of certain required hormones).

  • Encephalitis is the inflammation caused in the brain.

  • Genetic, hormonal anomaly in the pituitary, genital glands, pineal glands, adrenal glands, or endocrine glands.

  • The use of anabolic steroids (muscle-building injections) increases the risk of hypergonadism.

What Are the Possible Complications of Hypergonadism?

  • Polycythemia: Excessive hormone levels are linked with polycythemia, a blood cancer.

  • Reproductive Tract Malignancies: Reduced and increased hormone levels are associated with reproductive tract cancer.

  • Heart Problems: Increased levels of hormones can cause an unfavorable lipid profile giving rise to heart diseases.

  • Acne: Higher sebum secretion, changes in skin cellular activity, inflammatory processes, and colonization of hair follicles by the bacteria P. acnes can all be triggered by an increase in hormone levels. Acne can result from this.

  • Hirsutism: Hirsutism is a condition that causes the overgrowth of dark or rough hair on the face, chest, and back of women in a male-like pattern. Excess male hormones (androgens), particularly testosterone, are a common cause of hirsutism.

  • Pattern Hair Loss: U-shaped hair loss is seen in individuals who have hypergonadism.

  • Advent Mood Swings: When serotonin levels rise and fall rapidly, mood swings occur, resulting in an emotional roller coaster. Serotonin production is controlled by both male and female sex hormones, which increase and impact mood.

How Is Hypogonadism or Hypergonadism Diagnosed?

  • Peculiar clinical signs such as obesity, nephrotic syndrome, and thyroid problems are present.

  • Serum hormone levels are estimated.

  • Semen analysis is done to evaluate the constituents.

  • Iron saturation levels are calculated.

  • MRI (magnetic resonance imaging) of the brain helps in diagnosing disorders of the pituitary gland.

How Is Hypergonadism Treated?

The goal is to lower levels of hormones, which is more challenging than increasing hormone levels, thus making treatment for hypergonadism challenging. Excision and treatment of the malignancies of glands associated with the regulatory axis have proven helpful.

Is Menopause a Form of Hypogonadism?

Menopause is a natural occurrence of hypogonadism. It is characterized by the missed or absent menstrual cycle, flushes, insomnia, and reduced bone density. Menopause is a physiological part of a woman's life and does not require treatment. However, hormone replacement treatment can be utilized to cope with severe symptoms.

Conclusion:

Hypogonadism and hypergonadism are the two most common gonadal disorders caused by endocrine malfunction. Malignancies, trauma, and genetic disorders are among the other causes. When compared to hypogonadism, hypergonadism is a rare illness usually brought on by a more significant health issue. The underlying cause of hypergonadism can be treated to help regulate hormone levels and prevent hypergonadism consequences. Hypogonadism is a medical condition that affects men whereas it is manifested physiologically as menopause in women. Women may develop pathological hypogonadism as a result of radiation or surgery-induced menopause. In addition, gonadal abnormalities are linked to overall health because fluctuations can cause issues ranging from acne to cardiovascular disease.

Frequently Asked Questions

1.

What Are the Characteristic Features of Gonadal Function Disorder in Females?

The common clinical features seen in females with gonadal function disorder are as follows,
- Hirsutism (excessive unwanted male-pattern hair growth in females in areas such as the face, chest, and body).
- Infertility.
- Menstrual problems.

2.

What Causes Gonadal Disorder?

The leading cause of gonadal disorder is a disruption in the network of genes responsible for gene differentiation. Gene differentiation is a process where the development of ovaries and testes occurs in the embryo stage.

3.

What Is Hypergonadism?

Hypergonadism means overactive gonads. Gonads are reproductive glands. In men, the testes are the gonad, whereas, in women, the ovaries are the gonad. In the case of hypergonadism, women produce excessive levels of estrogen and men have excessive levels of testosterone.

4.

What Is Hypogonadism?

Hypogonadism means underactive sex glands that are gonads. In females, sex glands are ovaries, and in men, sex glands are testes. Underactive sex glands can lead to low sex drive and cause several other fertility issues.

5.

What Is Hypogonadotropic Hypogonadism?

The condition is hypogonadism when female ovaries and male testes produce less or no sex hormones. When hypogonadism occurs as a result of a problem with the pituitary gland or hypothalamus, then the condition is called hypogonadotropic hypogonadism.

6.

Which Hormones Are Responsible for the Function of Gonads?

A hormone named gonadotropin, produced by the pituitary gland, is responsible for the functioning of the male and female gonads, testes, and ovaries, respectively.

7.

What Are the Types of Gonads?

Gonads are reproductive glands present in males and females. In women, ovaries are the gonads that produce ova, and in men, testes are the gonads that produce sperms.

8.

Is Hypogonadism the Same as Low Testosterone Levels?

In males with hypogonadism, the levels of male sex hormones, such as testosterone, are lower than normal.

9.

How to Treat Hypogonadism in Men?

In males, hypogonadism can be treated with testosterone replacement therapy.

10.

What Happens if Hypogonadism Is Left Untreated?

Hypogonadism, if left untreated, can cause the following complications,
- Low sex drive or libido.
- Inability to gain physical strength or muscle mass.
- Osteoporosis (weak and brittle bones).
- If hypogonadism occurs in teenage, failure to attend puberty occurs.
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Dr. Raveendran S R
Dr. Raveendran S R

Sexology

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