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 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. Women with hypogonadism who have a low sex drive can also take low-dose testosterone.

In some women, injections or pills can be used to stimulate ovulation. Injections of pituitary hormone may be used to help male patients produce sperm. Other people may need surgery and radiation therapy.

Many forms of hypogonadism are treatable and have a good outlook.

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 take estrogen therapy especially 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 when hormone therapy is used to treat menopause symptoms.

In men, hypogonadism results in loss of sex drive and may cause:

• Impotence
• Infertility
• Osteoporosis
• Weakness

Men normally have lower testosterone as they age, but the decline is not as dramatic or steep as the decline in sex hormones that women experience.

Talk to your doctor if you notice:

• Breast discharge
• Breast enlargement (men)
• Hot flashes (women)
• Impotence
• Loss of body hair
• Loss of menstrual period
• Problems getting pregnant
• Problems with your sex drive
• Weakness

Both men and women should call their health care provider if they have headaches or vision problems.

Review Date: 10/14/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by Ari S. Eckman, MD, Chief, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)