The problem may be in the ovaries or testicles, or in the parts of the brain involved in sending hormones to them — the hypothalamus and pituitary. We call these two types primary and secondary hypogonadism.
This is when the sex glands don’t make enough or don’t make any sex hormones. In affected boys, the testicles don’t make testosterone well. In affected girls, the ovaries don’t make estrogen well. The cause may be one of these conditions:
- A genetic disorder (for example, Turner syndrome in girls, Klinefelter syndrome in boys)
- Certain autoimmune disorders
- A developmental disorder
- Radiation or chemotherapy
- An infection
- A surgery
Secondary (Central) Hypogonadism
In these types of hypogonadism, the ovaries or testicles (the gonads) aren’t the problem; the hypothalamus or pituitary gland in the brain is. The gonads don’t get the message to secrete hormones because of a problem earlier in the chain of commands.
- The hypothalamus: At the start of the process, the hypothalamus may be making too little or no gonadotropin-releasing hormone (GnRH)
- The pituitary: The middleman, the pituitary, may be making too little follicle-stimulating hormone (FSH) or luteinizing hormone (LH)