Aetiology

There are four aetiological classes of hypogonadism in the male (1):

• primary hypogonadism - ie hypogonadism due to testicular failure
  • congenital primary gonadal disease
  • acquired primary gonadal disease
    
    
• secondary hypogonadism - may be due to reduced gonadotrophins due to hypothalamic-pituitary disease
  • congenital e.g. Kallman's syndrome
  • secondary e.g. pituitary tumours
  • reversible secondary hypogonadism may also be the result of systemic illness e.g. (end-stage respiratory or renal disease), obesity, hyperprolactinaemia, long-term excessive exercise (1), poor nutritional status, supraphysiological doses of steroids, drugs (spironolactone, ketoconazole, marijuana)

Reference:

• 1. DTB 1999; 37 (1): 3-6.