The inability of the testicles to produce adequate testosterones (male hormone), or sperms, or both is called hypogonadism. The testicles produce testosterones and sperms when they receive a signal from the pituitary gland, attached to the base of the brain.

Hypogonadism can be caused by the testicles’ failure to produce testosterones and sperm despite receiving signals from the brain (primary hypogonadism) or due to problems in the pituitary gland (secondary hypogonadism). 

Risk factors include undescended testicles as infants, injury to the testicles, HIV/AIDS, testicular or pituitary tumours, exposure to radiation, Hemochromatosis, Klinefelter syndrome (genetic disorder where men inherit an extra X chromosome) or Kallmann syndrome (genetic disorder in which puberty fails to start or fails to fully complete).​​

Your symptoms for hypogonadism will depend on when the condition develops - before birth, before puberty or in adulthood.

Symptoms during foetal development include:

  • Impaired growth of sex organs

  • Female genitalia in boys

  • Genitals that are neither male nor female

Symptoms during puberty include:

  • Decreased development of muscle mass

  • Impaired growth of body hair

  • Impaired growth of penis and testicles

  • Lack of deepening of voice

  • Development of breast tissues 

Symptoms in adulthood include:

Other symptoms might include:

  • Fatigue

  • Hot flashes

  • Lack in concentration​​

Early diagnoses of hypogonadism can lead to successful treatment. You can consult our doctors at the Internal Medicine Service Line​ at the Aga Khan University Hospital, if you notice any of the above mentioned symptoms.​ ​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

On your initial visit, your doctor may conduct a physical exam to check your pubic hair growth, muscle mass, and the size of your testicles to gauge your sexual development. If your doctor detects symptoms of hypogonadism, you may be asked to undergo a blood test to check the levels of testosterone in your blood. 

Low levels of testosterones indicate that you suffer from hypogonadism. Further tests may be conducted to determine if the disease is primary or secondary hypogonadism. These tests will include:

  • Hormone testing

  • Semen analysis

  • Pituitary imaging

  • Genetics study

  • Testicular biopsy ​​

Your treatment options will greatly depend on your age and your personal preference and whether you want to retain the ability to father children or not. Discuss your options with your doctor before starting your treatment. Your treatment options will include:

  • Hormone replacement 

    • In case of primary hypogonadism, testosterone replacement therapy (TRT) maybe used which will also increase your sexual drive, muscle strength and a sense of well-being.

    • In case of secondary hypogonadism, pituitary hormones may be used to stimulate sperm production and restore fertility.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.​​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.