Treatments for Hypogonadism in Adult Males

Hypogonadism, sometimes referred to as andropause, is a condition characterized by the diminished production of testosterone in the body. It is in some way analogous female menopause, which is often characterized by the diminished production of estrogen in the body. It can occur at birth or develop late in life, and although confusing and embarrassing, there is treatment to help reverse the effects and stimulate the normal production of testosterone in the body.

Causes/Symptoms

• Two types of hypogonadism exist in adult males: primary, which occurs when the testicles no longer produce testosterone due to a variety of factors such as injury or aging; and secondary, which occurs when the hypothalamus or pituitary gland ceases to properly function, caused by inflammatory diseases, HIV and medications, among others. Symptoms of the condition in adult males may include sexual dysfunction, gynecomastia (enlarged breasts), osteoporosis, fatigue, hot flashes and problems concentrating. If you experience any of these symptoms, consult a doctor as quickly as possible to rule out anything more serious and to begin prompt treatment.

Treatment

• For adult males, treating hypogonadism is focused heavily on hormone therapy. If the source of the diminished testosterone is the testicles, testosterone replacement therapy is utilized. In the event the hypogonadism is caused by a problem with the pituitary gland, replacement pituitary hormones are used to restore fertility by increasing the production of sperm. In some cases, other medical interference is necessary, such as surgery to remove the pituitary gland or a tumor that may be causing the hypogonadism. Fertility issues that cannot be reversed for whatever reason can be treated with assisted reproduction, which is focused on helping infertile couples have children through means other than standard intercourse.

Methods

• There are several methods through which the testosterone hormones can be administered; discuss with your doctor the best option for your individual case. These include:

  Injections, which are administered into a muscle approximately twice a month. It is safe and can be done either by a doctor or in the comfort of your own home.

  Testosterone patches known as Androderm, which are applied to various points on the body every week to avoid the risk of irritating the skin.

  Gel, which is absorbed through skin once it dries. It is typically applied to the abdomen, arms or shoulders.

  Buccal cavity delivery, which involves placing a substance with the consistency of putty where the upper lip and the gums meet. The putty softens when it comes into contact with saliva, allowing the gums to absorb the testosterone.

  Oral replacement therapy, which is simply in the form of a pill.

Side Effects

• Testosterone replacement is generally regarded as safe, though some methods carry potential side effects. If injected, the primary side effect is localized skin irritation. This can also occur with patches, especially if used in the same place more than once. Gel applications can cause side effects for others, such as excessive hair growth in women. Since the gel can be transferred via direct contact, avoid contact with anyone until the gel has completely dried and been washed. Wash your hands immediately after applying the gel. Finally, oral testosterone replacement theory is often not recommended due to the potential for liver damage, a spike in cholesterol and an increased risk for the development of heart disease.

Differences

• Treatment for hypogonadism in adult males serves a different purpose than treatment used in young boys. Treatment for an adult male is focused on reversing any negative sexual effects, such as erectile dysfunction or a diminished sex drive, and restoring fertility. The latter is especially important as many men who experience this condition may be young and still hope to have children one day. Conversely, in young boys, using replacement hormones is designed to emulate the effects of puberty, providing normal growth of the body, hair and penis, as well as helping develop muscle mass.