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What Causes Male Hypogonadism?

Male hypogonadism is a condition in which the testes/testicles does not produce adequate amount of testosterone, which is the hormone that plays a key role in sexual, cognitive, body function and development. There are two types of male hypogonadism

Primary Male Hypogonadism: This is also called primary testicular failure and the problem is in the testicles.

Secondary Male Hypogonadism: In secondary hypogonadism the problem is in the hypothalamus or in the pituitary gland. The hypothalamus produce gonadotropin-releasing hormone (GnRH) and it stimulates the pituitary gland to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH acts on the testes and signals the testes to produce testosterone.

What Causes Male Hypogonadism?

What Causes Male Hypogonadism?

Even though the causes of male hypogonadism are divided into primary and secondary, sometimes both can occur at the same time.

Causes of Primary Male Hypogonadism

Undescended Testis: Undescended testis can cause male hypogonadism. In a male fetus the testicles develop in the abdomen and it gradually descend down the inguinal canal to its final position the scrotum. Usually when a male baby is born the testicles is already in the scrotum. But, sometimes one or both the testicles may not have descended by birth. The testes can descend itself without any treatment within the first year of life. If not it should be surgically placed inside the scrotum. If not corrected the testicles function will stop and there will not be any testosterone or sperm production.

Klinefelter Syndrome. Klinefelter Syndrome can cause male hypogonadism. It is a genetic condition, an abnormality of the sex chromosomes. Normal chromosomal pattern in a male is XY. Klinefelter syndrome people have XXY (additional X). The extra X chromosome in Klinefelter syndrome cause abnormal development of the testicles and cause testosterone deficiency.

Mumps Orchitis: Mumps infection usually involves the salivary glands. If a male gets the mumps infection during adolescence or adulthood then there is a chance of getting mumps orchitis, which can damage the testicles and cause testosterone deficiency and problems with sperm production.

Injury To The Testicles: Testicles are situated outside of the abdomen therefore, it is more prone to trauma and injury. Injury to testes can cause male hypogonadism. Damage to both testicles can cause hypogonadism but, if only one testis is damaged there will be some less amount of testosterone production.

Hemochromatosis: Hemochromatosis is a condition when there is an excessive amount of iron in the blood. Iron can deposit in the testicles and can cause male hypogonadism. It also can deposit in the pituitary gland and cause secondary hypogonadism.

Cancer Treatment: Chemotherapy and radiotherapy can interfere with the normal testosterone and sperm production and can cause male hypogonadism. Most of the time these effects are temporary, but permanent infertility can occur.

Normal Aging: With age, the normal testosterone production gradually reduces. Therefore, older men have reduced testosterone levels than younger males and may develop male hypogonadism.

Causes of Secondary Male Hypogonadism

Pituitary Disorders: Problem in the pituitary gland blocks the hormones secreted by the pituitary gland and this reduce the production of testosterone in the testicles causing male hypogonadism. Pituitary gland tumor, brain tumor adjacent to the pituitary, surgical treatment of the pituitary gland can cause damage to the pituitary.

Kallmann Syndrome: Genetic condition that causes congenital hypogondotrophic hypogonadism due to a problem in the secretion of GnRH in the hypothalamus. This causes secondary male hypogonadism.

Inflammatory Diseases: Some inflammatory conditions like histiocytosis, sarcoidosis and tuberculosis can involve the hypothalamus and pituitary gland and this affect the testosterone production and cause male hypogonadism.

Medications: Opiate pain medications and some hormones can affect testosterone production.

Obesity. Being overweight can cause male hypogonadism at any age.

HIV/AIDS. It causes low testosterone by affecting the hypothalamus, pituitary and testes.

Stress-Induced Hypogonadism: Stress, excessive physical activity, underweight all leads to male hypogonadism. The exact mechanism is unknown; however, it can be due to excess cortisol production with stressful activities and suppressing the hypothamus


Male hypogonadism is a condition in which the testes/testicles does not produce adequate amount of testosterone, which is the hormone that plays a key role in sexual, cognitive, body function and development. There are two types of male hypogonadism, primary and secondary hypogonadism. In primary hypogonadism the problem is in the testicles. Causes of primary hypogonadism includes undescended testis, Klinefelter syndrome, injuries to the testis, mumps orchitis, hemochromatosis, normal aging and cancer treatment. In secondary hypogonadism the problem is in the hypothalamus or in the pituitary gland. Causes for secondary hypogonadism include pituitary disorders, Kallmann syndrome, inflammatory diseases, medications, obesity, HIV/AIDS and stress-induced hypogonadism.


  1. Mayo Clinic – Male Hypogonadism: https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881
  2. WebMD – Hypogonadism: Causes and Treatment: https://www.webmd.com/men/what-is-hypogonadism
  3. National Institute of Diabetes and Digestive and Kidney Diseases – Hypogonadism: https://www.niddk.nih.gov/health-information/endocrine-diseases/hypogonadism
  4. Cleveland Clinic – Hypogonadism: https://my.clevelandclinic.org/health/diseases/4046-hypogonadism
  5. American Urological Association – Hypogonadism: https://www.auanet.org/guidelines/testosterone-deficiency-guideline

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 2, 2023

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