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What Is Late-Onset Hypogonadism?

What Is Late-Onset Hypogonadism?

It is quite evident that the effect of aging reduces the action of cellular functioning in the body. Late-onset hypogonadism is one of those functional disorders which occur due to aging. With the increase in age, the testosterone level of the body is decreased.

The male hypogonadism is due to low level of testosterone and it impacts the quality of life and various physiological functions of the body. It is very well documented that the amount of testosterone reduces with age. The condition of late onset hypogonadism is defined by the presence of at least three symptoms i.e. reduced libido; reduced spontaneous erection and erectile dysfunction and is also having the level of free testosterone below 220 pmol/l. In case of late onset hypogonadism, the reasons are in combination of both primary and secondary hypogonadism. The late-onset hypogonadism is also known as age-related hypogonadism. This disease is a well-defined condition, both clinically and analytically, wherein the level of the testosterone is quite low and impacts general functioning of the body.

What Is Late-Onset Hypogonadism?

The aging process in males results in the decreased efficiency at both the primary as well as the secondary level. At the primary level, the testis fails to produce the normal amount of testosterone due to atherosclerosis and degeneration in Leydig cells. Leydig cells are the cells which are primarily responsible for secretion of testosterone. There is an age related deterioration that also occurs in Hypothalamic-pituitary region which results in the abnormal signaling for the release of testosterone from Leydig cells. Sex Hormone Binding Globulin increases with age, this result in the binding of testosterone and the concentration of free testosterone further reduces. Further, the aromatase activity also increases which further complicate the situation.

Hypogonadism Symptoms

Symptoms Of Hypogonadism In Males

The level below 280 ng per deciliter indicates a low level of testosterone. Following are the symptoms that may be experienced by males in cases of hypogonadism:

  • Low sex drive.
  • Erectile dysfunction.
  • Reduced body hair
  • Low muscle mass
  • Non-deepening of voice.
  • Delayed puberty
  • Abnormal development of sperm
  • Male infertility

Symptoms Of Hypogonadism In Females

Following are the symptoms of female hypogonadism:

The hypogonadism is defined as the reduced activity of the gonads. The gonads in males are testes and in females it is ovary. The hypogonadism results in the decrease in release of the sex hormones, due to which the patient experiences variety of symptoms. The most critical impact of hypogonadism is the infertility as the hypogonadism in male results in the low sperm production or erectile dysfunction while in female it may result in the Polycystic ovary syndrome or may impact the development of eggs. The severity of hypogonadism depends upon the extent of reduction in capacity to produce sex hormones. The pituitary produces a trigger due to which the hormone is release form the gonads. Thus, on the basis of the site of disorder, the hypogonadism can be divided in to two types:

  1. Primary Hypogonadism: When the gonads are unable to synthesize and release the sex hormones such as in Turner syndrome.
  2. Secondary Hypogonadism: When the pituitary or hypothalamus is unable to cause a trigger in the gonads as in case of Kallmann syndrome.

Further, the hypogonadism may be from birth known as congenital hypogonadism or it may be due to certain condition acquired later in the life known as acquired hypogonadism.

The hormones generally involved in hypogonadism are testosterone in males and estrogen in females.


Late-onset hypogonadism is the condition related to aging. As the age increases, testosterone level reduces. Late onset hypogonadism is a well defined condition characterized by at least three symptoms i.e. low libido, reduced spontaneous erection and erectile dysfunction. In severe reduction of testosterone levels, testosterone replacement therapy is recommended.


  1. Mayo Clinic – Male Hypogonadism: https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881
  2. Cleveland Clinic – Hypogonadism: https://my.clevelandclinic.org/health/diseases/15638-hypogonadism-low-testosterone
  3. Endocrine Society – Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes: https://www.endocrine.org/clinical-practice-guidelines/testosterone-therapy-in-adult-men-with-androgen-deficiency-syndromes
  4. PubMed Health – Hypogonadism: https://www.ncbi.nlm.nih.gov/books/NBK279053/

Also Read:

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 3, 2023

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