What is Male Hypogonadism
Male hypogonadism is a medical condition in which the body is unable to produce enough sperm and/or testosterone. One can be born with male hypogonadism or develop it later in life, often due to age. Testosterone levels are crucial in maintaining several body functions in males, like:
- Sperm production
- Sex drive
- Muscle strength/mass
- Bone density
- Fat distribution
- Red blood cell production
Testosterone affects a male’s libido and sex drive. This is a big worry for men, since their sexual performances and desires are likely to be affected.
The decrease in testosterone level can lead to physical changes such as:
- Increased body fat
- Fragile bones
- Decreased body hair
- Diminished mass/strength of muscles
- Hot flashes
- Tenderness in the breast tissue
- Increased fatigue
- Effects on cholesterol metabolism
Symptoms Of Male Hypogonadism
Male Hypogonadism can be developed in various stages in life. Depending on when it is developed, symptoms may vary.
But it is more prevalent in adult males. This usually changes a few physical characteristics and affects normal reproductive function.
Symptoms include:
- Infertility
- Erectile dysfunction
- Decreased muscle mass
- Slow growth of body and beard hair
- Loss of bone mass
- Development of breast tissue
- Fatigue
- Reduced sex drive
- Hot flashes
- Difficulty in concentrating
Causes Of Male Hypogonadism
There are two types of Male Hypogonadism – primary and secondary hypogonadism. Each of these are caused by varying factors.
Primary Hypogonadism
Primary hypogonadism originates from issues in the testicles.
Common causes include:
- Klinefelter Syndrome: In most cases a male has one Y and X chromosome. Someone with Klinefelter Syndrome may have two X and one Y chromosome. This causes abnormal development of testicles and thus underproduction of testosterone.
- Mumps Orchitis: If a mumps infection affects the testicles along with the salivary glands, long-term testicular damage may take place. This may affect usual testosterone production and testicular function.
- Undescended Testicles: Before birth, the testicles form inside the abdomen and move down into the scrotum. Yet, at times one or both of the testicles may still remain in the abdomen. This condition usually corrects itself during the initial years without treatment. If it does not get corrected, it may lead to reduced production of testosterone and malfunction of the testicles.
- Injury to the testicles: Testicles are prone to injury since they are located outside the abdomen. Any damage to developed testicles may result in hypogonadism. Though damage to one testicle might not affect the total testosterone production.
- Hemochromatosis: Having too much iron in the blood can lead to pituitary gland dysfunction or testicular failure.
- Cancer Treatment: Chemotherapy and radiation therapy can affect sperm and testosterone production. Although the effect of both treatments is temporary, they may cause permanent infertility. This is why many men consider preserving their sperm before beginning cancer therapy.
Secondary Hypogonadism
In Secondary Male Hypogonadism, the issue is not with the testicles. The problem lies with pituitary gland or hypothalamus.
Here are some likely causes:
- Kallmann Syndrome: Abnormal development of the hypothalamus. This is the brain area that monitors the secretion of pituitary hormones.
- Inflammatory Disease: Inflammatory diseases that involve the pituitary gland can impact testosterone production. Hence, causing hypogonadism.
- Pituitary Disorders: Impairment in the pituitary gland can affect the secretion of hormones to the testicles. influencing normal testosterone production. A pituitary tumor or tumor located near the pituitary gland can cause testosterone or hormone deficiencies. Additionally, treatments such as radiation therapy or surgery for a brain tumor may impair pituitary function and lead to hypogonadism.
- HIV/AIDS: Contracting AIDS can lead to low levels of testosterone by impacting the hypothalamus, the testes, and the pituitary.
- Obesity: Being obese at any age may lead to hypogonadism.
- Medications: The use of specific drugs like opiate pain medicines may impact testosterone production.
- Concurrent Illness: The reproductive system can shut down temporarily due to the physical and emotional stress of surgery or illness. This is due to decreased signals from the hypothalamus and generally resolves with treatment of the underlying condition.
Diagnosis Of Male Hypogonadism
Usually doctors will observe how your physical developments are. For example, if your muscle mass, size of testes, and pubic hair, is consistent with your age. The most accurate way is to test testosterone levels in your blood.
If the tests confirm that you have low testosterone levels, the doctor will take further tests to determine the cause. Based on the specific symptoms and signs, additional tests might be taken to find out the underlying cause. These studies may include:
- Semen analysis
- Hormone testing
- Genetic studies
- Pituitary imaging
- Testicular biopsy
Treatment Of Male Hypogonadism
1. Synthetic Drugs
- Injections: Your doctor can inject the hormone into a muscle every two-three weeks. Testosterone injections (testosterone enanthate, testosterone cypionate) are effective and safe. You or your family member can give TRT injections at home or use professional help.
- Pills: You can consume testosterone in a pill form. However, oral testosterone may cause a rise in cholesterol levels and increase the risk of liver and heart problems over time. For this reason, pills are not usually considered for long term use.
- Buccal Cavity: A small putty-like substance, cheek and gum testosterone replacement (Striant) transfers testosterone through the natural cavity above your top teeth where your upper lip and gum meet (buccal cavity.) This product in the form of a tablet sticks to your gumline quickly, softens, and then lets testosterone to be absorbed in your bloodstream.
- Testosterone Pellets: Testosterone pellets like Testopel measure 3mm by 9mm, and contain crystalline testosterone. The doctor will perform a simple and short procedure in their office to implant the pellets under your skin, mostly near your hip. These pellets slowly release testosterone over a period of three to six months. They are a long-acting form of TRT. They deliver a steady and stable dose of testosterone, typically providing the required level of testosterone for four months.
2. Vitamins
- D-Aspartic Acid: A natural amino acid that is capable of boosting low testosterone levels. According to a research, it works by improving luteinizing hormone and follicle-stimulating hormone. Luteinizing hormone is important as it makes the Leydig cells in testes generate more testosterone. D-asparitic acid may aid in sperm production and quality as well. One ninety-day study concluded that giving D-aspartic acid to men with flawed sperm production resulted in two times (16.5 million) the initial sperm count (8.2 million).
- Zinc: Known as an aphrodisiac, zinc is amongst the essential minerals involved in more than 100 chemical processes within the body. Zinc levels have been closely linked to testosterone levels. One study found that restricting zinc consumption from foods decreased testosterone levels in healthy men. On the other hand, increasing zinc in zinc-deficient males increased testosterone levels. Additionally, taking zinc supplements everyday helped the participants increase testosterone levels after a four-week high-intensity training regime.
- Vitamin D: A fat-soluble vitamin formed in the skin when exposed to sunlight. Since a large portion of the population does not experience sufficient exposure to the sunlight, a lot of us lack Vitamin D. In a yearlong study, two groups of 32 people each were researched upon. One of the groups was to take 3,300 IU of Vitamin D each day. This group’s Vitamin D levels doubled and there was 20% increase in their testosterone levels. You can stay in the sunlight for long to increase Vitamin D levels or include rich sources of Vitamin D like fatty fishes, salmon, cereal, and dairy products.
3. Topical Medications
- Skin Patch: You can place a testosterone skin patch on your body at night. You must shift the patch to a different part of your body every few weeks. This helps in reducing the risk of developing an adverse site reaction. You can consider rotating the site of application, among your thigh, back, abdomen or upper arm.
- Gel: There are multiple gel applications containing testosterone offered by various brands. Based on the brand, you can rub testosterone gel onto the skin of your upper arm, shoulder, lower abdomen, inner thigh, or armpits. Your body absorbs testosterone through the skin as the gel dries. Gel application or TRT appears to cause lesser skin reactions as compared to patches. You must avoid bathing for a few hours so that your skin absorbs the gel completely. Additionally, you must avoid skin-to-skin contact with anyone until the gel dries to avoid it being transferred to the other person. You can choose to cover the area to prevent it from transferring. You can also pump testosterone gel into your nostrils. People choose this option because it reduces the risk of transferring the medication to another person through skin contact. Nasal-delivered testosterone requires to be applied twice in each nostril, three times a day.
4. 100% Herbal Supplements To Boost Testosterone
It is not known whether using TRT for long term is safe and beneficial. A great safe and natural alternative is herbal supplements.
- Herbal Supplements: Herbal supplements, such as Tongkat Ali, Ashwagandha, Maca and Hony Goat Weed. These are considered safe alternatives to pharmaceutical drugs. In addition to treating hypogonadism, these herbal supplements reduce anxiety, increase muscular strength, and improve physical performance, as proven by several research studies.
5. Naturally maintain Testosterone
- Get Enough Sleep: You must sleep for at least 7 hours each night. According to a study, testosterone levels dropped in those men who did not sleep enough. The researchers found that after only a week of restricted sleep, the testosterone levels dropped by 15 percent.
- Maintain A Healthy Diet: You must maintain a healthy diet with whole foods and has the right balance of carbohydrates, fats and proteins. According to studies, yo-yo dieting, as well as overeating, may lead to disruption in hormone levels and lead to inflammatory conditions. The research also found that eating well is necessary to maintain testosterone levels and health. As per several studies, drug and alcohol abuse also affects hormones and glands involved in male reproductive health. So, you must stay away from intoxications to increase your testosterone levels.
- Lost Weight And Stay Active: Research has found that more weight means low levels of testosterone in some males. Additionally, males who are more active tend to have higher levels of testosterone. So, you can work out to shed those extra pounds and increase the testosterone levels in your body.
The Bottom Line
Testosterone is a vital hormone that influences many bodily functions. This spans beyond just sperm production and libido, but includes muscle growth, metabolism and behavioral traits, among others. If we do not pay attention to our testosterone levels, we may be sacrificing our quality of life, when remedy is widely and readily available.
Male Hypogonadism is a common condition, especially as men get older. Proper diagnosis can help determine the underlying issue, thereafter identifying suitable treatments. Avoiding medication and invasive prescriptions? There are alternative sage treatments that are widely available, which are natural and limit side effects.
Whichever treatment you decide on, seek professional advice before embarking on them
References:
https://www.uptodate.com/contents/causes-of-primary-hypogonadism-in-males
https://www.medicalnewstoday.com/articles/307634.php
https://www.healthline.com/health/hypogonadism
https://www.medpagetoday.com/resource-centers/hypogonadism/acquired-causes-secondary-hypogonadism-adult-male-/1105
