Diagnosis
4
Table 1. Classification of Hypogonadism and Causes of
Primary and Secondary Hypogonadism
Primary Hypogonadism Secondary Hypogonadism
ORGANIC
• Klinefelter syndrome (KS)
• Cryptorchidism, myotonic dystrophy,
anorchia
• Some types of cancer chemotherapy,
testicular irradiation/damage,
orchidectomy
• Orchitis
• Testicular trauma, torsion
• Advanced age
• Hypothalamic/pituitary tumor
• Iron overload syndromes
• Infiltrative/destructive disease of
hypothalamus/pituitary
• Idiopathic hypogonadotropic
hypogonadism
FUNCTIONAL
• Medications (androgen synthesis
inhibitors)
• End-stage renal disease
a
• Hyperprolactinemia
• Opioids, anabolic steroid use,
glucocorticoids
• Alcohol and marijuana abuse
a
• Systemic illness
a
• Nutritional deficiency/excessive exercise
• Severe obesity, some sleep disorders
• Organ failure (liver, heart, and lung )
a
• Comorbid illness associated with aging
a
a
Combined primary and secondary hypogonadism, but classified to usual predominant
hormonal pattern. Adapted with permission from Bhasin et al. J Clin Endocrinol
Metab. 2010;95(6):2536–2559.
