Gonadal deficiency
Hormone-based medicines are available for men and women. Estrogen comes in the form of a patch or pill. Testosterone can be given by using a patch, a product soaked in by the gums, a gel, or by injection.
For women who have not had their uterus removed, combination treatment with estrogen and progesterone is often recommended to decrease the chances of developing endometrial cancer. In addition, low dose testosterone can be added for women with hypogonadism who have a low sex drive.
In some women, injections or pills can be used to stimulated ovulation. Injections of pituitary hormone may be used to help male patients produce sperm. In others, surgery and radiation therapy may be needed.
Many forms of hypogonadism are potentially treatable and have a good prognosis.
In women, hypogonadism may cause infertility. Menopause is a form of hypogonadism that occurs naturally and can cause hot flashes, vaginal dryness, and irritability as a woman's estrogen levels fall. The risk of osteoporosis and heart disease increase after menopause.
Some women with hypogonadism opt to take estrogen therapy, particularly those who have early menopause (premature ovarian failure). However, there is a small but significant increase in risk for breast cancer and possibly heart disease with use of hormone therapy for treatment of menopause symptoms.
In men, hypogonadism results in loss of sex drive and may cause weakness, impotence, infertility, and osteoporosis. Men normally experience some decline in testosterone as they age, but it is not as dramatic or steep as the decline in sex hormones experienced by women.
Consult with your doctor if you notice loss of menstruation, breast discharge, problems getting pregnant, hot flashes (women), impotence, loss of body hair, weakness, breast enlargement (men), or problems with your sex drive. Both men and women should call their health care providers if headaches or visual problems occur.
Sigman M, Jarow JP. Male infertility. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007: chap 19.
Molitch ME. Anterior pituitary. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 242.
Swerdloff RS, Wang C. The testis and male sexual function. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 253.
White PC. Disorders of sexual differentiation. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 252.