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Primary Hypogonadism and Primary Testicular Failure

While hypogonadism sounds like a horrible, disfiguring illness, it’s actually the medical term for low testosterone. This rather common and treatable condition is broken down into two types — primary hypogonadism and secondary hypogonadism.

primary hypogonadism

Secondary hypogonadism could be thought of as crossed wires or a problem with your body’s operating system — your biochemical communication network of hormones is malfunctioning. Secondary hypogonadism is often a problem intrinsic to the pituitary gland.

Even though the body’s machinery responsible for testosterone production is in good working order, it’s simply not getting the messages that tell it when and how to do its job, to produce the needed quantities of testosterone (or other hormones).

Primary hypogonadism generally refers to a condition that is more severe, and, often, more permanent. Basically, you have a hardware malfunction — the machinery in your body that produces hormones is damaged in some way.

(This earlier post from our blog provides a more complete overview of hypogonadism.)

What Is Primary Hypogonadism?

Primary hypogonadism is often referred to as primary testicular failure — your testicles are not able to produce the necessary testosterone for balanced hormone levels, often due to injury or trauma.

You are likely to experience symptoms of low testosterone as a result, such as the following:

  • Fatigue
  • Sexual dysfunction
  • Weight problems
  • Trouble concentrating
  • Loss of endurance
  • Depressed mood
  • Muscle weakness and loss

In the case of low testosterone, the shortage of testosterone leading to your symptoms is caused by testicular trauma leading to testicular failure.

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Primary Testicular Failure — The Causes

Testicular trauma can refer to injury, medical treatments involving harsh chemicals or radiation that hinder testicular function, or removal of the testicles to treat cancer.

Low Testosterone and Testicular Removal

This is the most obvious type of “testicular trauma” — removal of one or both testicles can be necessary in the event of accidental injury or as a part of cancer treatment.

When only one testicle is removed, there is usually a severe, initial drop in testosterone production. However, in many cases, the remaining testicle will pick up the slack by increasing production, resulting in a return to more-or-less normal testosterone levels (though this is not always the case).

Removal of both testicles leads a total loss of testosterone production, necessitating hormonal replacement therapy.

Primary Hypogonadism and Radiation and Chemotherapy

Harsh treatments for cancer can result in the testicles ceasing to function, or functioning at lower-than-optimum levels.

This is usually temporary, and the testicles could return to more normal function some time after the radiation or chemotherapy has been completed.

Unfortunately, this is not always the case — the physical trauma caused by these harsh (but often life-saving) treatments can sometimes cause a permanent reduction in testosterone production.

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Other Medical Causes of Primary Hypogonadism

The following are some medical conditions that can result in testicular trauma, which then leads to primary hypogonadism:

  • Klinefelter’s syndrome
  • Adolescent mumps (or other infections) causing extreme swelling of the testicles
  • Undiscovered or untreated tumors and cancer

Primary hypogonadism, or testicular failure, is found to be the most common cause of low testosterone in younger men.

Primary Testicular Failure and Treatment With TRT

If you suffer from primary hypogonadism, a treatment regimen of supplementary testosterone is recommended.

This article from The National Center for Biotechnology Information sums up the benefits of testosterone replacement therapy (TRT) for men suffering from all forms of low testosterone, including primary hypogonadism:

“For men who have the diagnosis of primary or secondary hypogonadism with symptoms referable to consistently low serum testosterone levels, testosterone replacement should be offered because most studies show that benefits outweigh potential risks. In most studies in hypogonadal men receiving testosterone replacement, improvement in sexual function and lean mass, decrease in fat mass and increase in bone mineral density are more consistent in younger than older men.”

Those are much needed benefits for someone suffering from primary hypogonadism. Treatment can make all the difference, especially when you consider that the effects of testicular trauma may be permanent.

Learn More About Primary Hypogonadism in Young Men

For younger men, especially those under 30, primary hypogonadism is the most likely cause of low testosterone, but there can also be other reasons behind the condition — click the button below to find out more about low testosterone in young men.

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(Bill) William J. White, PA-C

(Bill) William J. White, PA-C brings over 20 years of surgical experience to our practice. He is a decorated veteran of the United States Army where he served for nearly 6 years with duty assignments, both here and abroad.   During his military career, Bill was trained as a Certified Surgical Technologist, and following an Honorable Discharge from the Army, he attended Texas Tech University.   He graduated with a Bachelor of Science in Biology and went on to attend PA School at the University of Texas Southwestern Medical Center at Dallas. He spent the first 10 years of his career in Neurosurgery.

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