Several forms of hypogonadism exist, depending on the cause. A disorder on the level of the pituitary usually results in low levels of circulating FSH and LH (hypogonadotropic hypogonadism). In this case, the gonads do not receive enough input in order to produce mature germ cells and adequate amounts of steroid hormones. On the other hand, FSH and LH levels can be very high, due to dysfunctioning gonads (hypergonadotropic hypogonadism).
In the table below, different causes for hypogonadism are mentioned. Gonadotropin therapy is used to treat anovulation on the level of the pituitary or ovary and for assisted procreation as in vitro fertilisation, intra-uterine insemination. Beyond child wish, a combination of estrogen/progesterone or androgen substitution is required in primary hypogonadism.
- male: Klinefelter syndrome, orchitis (due to mumps or tuberculosis), radiation, trauma
- female: Turner syndrome, ovary resistance, gonadal agenesia
- male: panhypopituitarism, Kallmann syndrome, anorexia
- female: stress, anorexia, top-class sport
I. GnRH analogues are never effective in treating secondary hypogonadism.
II. Amenorrhea can be due to hypogonadism.
Extra info: Secondary hypogonadism is caused by insufficient secretion of gonadotropic hormones. By administering GnRH analogues, the release of gonadotropic hormones from the pituitary can be stimulated. Decreased LH/FSH levels can result in the absence of follicle maturation and, consequently, also in decreased estrogen and progestagen levels. All these events result in amenorrhea.