A low level of testosterone is known as hypogonadism in medical terms. Depending on where the deficiency in testosterone production occurs, it can be classified as primary, secondary, or tertiary hypogonadism. Primary hyponadism is diagnosed when the problem occurs in the organs that make testosterone, the testicles. When it is damage to the hypothalamus that causes testosterone deficiency, the condition is known as tertiary hypogonadism.

Regardless of where the problem originates, low testosterone levels can have a profound impact on the way a man’s body functions, and he’s likely to experience the effects in a number of different areas. The classification of primary, secondary, or tertiary hypogonadism is important because it will influence the course of treatment your doctor prescribes.

What is primary hypogonadism?

Primary hypogonadism will be diagnosed when there is a problem with the Leydig cells on tests that make testosterone. This is a primary failure at the organ level, which means that biologically the body cannot make enough testosterone. There are a number of factors that can affect damage to the testicles.

Some of the factors that can cause primary hypogonadism include:

Tests not descended

If the testes do not descend during fetal development or within the first year or two of life, permanent damage can occur. This could affect the ability of the testicles to produce enough testosterone to keep the body healthy.

scrotal injuries

Physical damage and injury to the scrotum can affect testosterone production. Often, however, if only one testicle is damaged, the other may produce enough to compensate, as part of the body’s commitment to homeostasis. Most of the time, the problem arises when both testicles are damaged.

cancer treatment

Cancer treatments, such as radiation therapy or chemotherapy, can damage the cells that make testosterone.

Aging

Once you reach your middle age in life, your testosterone production naturally declines. This part is part of normal life cycles and processes that slow down once you start to age. Testosterone production decreases by 1-2% each year once you pass the age of 30.

Mumps

Mumps can cause swelling and inflammation of the testicles, which affects the production of sex hormones.

genetic abnormalities

Klinefelter syndrome is an example of a genetic abnormality that can affect the levels of testosterone produced by the body. With this syndrome, an extra x chromosome finds its way into the genetic makeup and the body cannot produce enough testosterone.

Tertiary hypogonadism

Secondary and tertiary hypogonadism occurs when the glands that produce the hormones that make testosterone do not work at their best or are damaged. This could include damage to the pituitary gland or hypothalamus, or other glands that make hormones like LH, TSH, and GRH.

Some of the problems that can cause tertiary hypogonadism may include:

• Tumors in the pituitary glands or side effects of brain tumors can affect testosterone production.
• Malformation of the hypothalamus, which usually occurs during fetal development, can cause low testosterone levels.
• Poor circulation or insufficient blood flow to the pituitary gland and hypothalamus can cause them to not produce sufficient hormone levels.
• Sarcoidosis or tuberculosis can cause inflammation of the pituitary gland, affecting its functionality.
• Steroid use or abuse can also affect the way the hypothalamus works.

Obesity is another factor that can affect a man’s ability to produce enough testosterone to keep the body healthy. If a man is overweight or obese, the excess fat cells in the body convert testosterone to estrogen, which significantly reduces the amount of testosterone circulating in the body. This is a cyclical problem where both obesity and low testosterone levels require treatment to correct.