Men’s Health
Hypogonadotropic Hypogonadism in Men
We offer you personalized care for male infertility and other symptoms of low testosterone from pituitary and hypothalamic disorders.
Medically reviewed by Marc Dall'Era, M.D. on April 07, 2026.
Understanding Hypogonadotropic Hypogonadism in Men
Hypogonadism is a condition where your testicles don’t produce enough testosterone hormone or sperm. Both are important for your sexual development and fertility. The difficulty could originate in your testes or in your brain.
Your brain’s hypothalamus and the pituitary gland in your head produce hormones to regulate testosterone and sperm production. If they don’t send the right hormone signals to your testicles, it’s called hypogonadotropic hypogonadism (HH or secondary hypogonadism).
Hormones you may be lacking from hypogonadotropic hypogonadism are:
- Follicle-stimulating hormone
- Gonadotropin-releasing hormone
- Luteinizing hormone
UC Davis Health urology specialists offer compassionate care for hypogonadotropic hypogonadism (HH) in men. We are experts in diagnosing hormone-related male infertility. We use the latest treatments to support your health and improve your chances for conception.
On this page
Symptoms of Decreased Testosterone
Secondary hypogonadism has symptoms related to physical and sexual development in children and adults. We review your symptoms to determine the best treatment for your stage of life.
Child Symptoms
Most childhood symptoms of secondary hypogonadism relate to delayed or incomplete growth and sexual development.
- Facial hair that doesn’t grow
- Inability to smell
- Penis and testicles that don’t enlarge during puberty
- Short stature
- Voice that doesn’t deepen
Adult Symptoms
Adult men may have the following HH symptoms:
- Changes in mood
- Declining muscle mass
- Fatigue
- Infertility
- Little interest in activities
- Loss of armpit or pubic hair
- Reduced sex drive (libido)
- Weight gain
Secondary Hypogonadism Causes
Hypogonadotropic hypogonadism can be present at birth (congenital) or develop later in life. Our urologists are experts at diagnosing the cause of secondary hypogonadism to help you find a path forward.
Damaged Hypothalamus and Pituitary Gland
Injury, infection, tumors and radiation can damage your hypothalamus and pituitary gland and affect signals from your brain.
Genetic Disorders
HH is common with some genetic conditions, such as congenital Kallmann syndrome.
Medical Conditions
Secondary hypogonadism can develop from chronic illness and inflammation. Certain other medical conditions, such high levels of iron (hemochromatosis) or prolactin hormone, can cause HH.
Medications
Using heroin, opioids, steroids and testosterone supplements may cause HH.
Stress
Stress affects your physical and mental health in many ways, including causing HH.
Weight
Obesity and rapid weight gain or loss upset your body’s natural functions.
Secondary Hypogonadism Diagnosis and Testing
Our specialists use the latest procedures to diagnose HH and monitor your treatment. Your urologist will review your symptoms and family medical history. They also perform a physical exam. You may have these tests:
Blood Tests
Blood tests check your hormone and iron levels.
Genetic Testing
Genetic testing identifies inherited problems with your genes that affect HH.
MRI
An MRI looks for tumors or other issues in your hypothalamus and pituitary gland.
Semen Analysis
Semen analysis assesses the quality and quantity of your sperm.
Hypogonadotropic Hypogonadism Treatment
We treat HH with hormone therapy and medication to stimulate puberty and improve your fertility. Treatment is given as injections, skin patches, gels and pills, depending on the nature and severity of your condition.
We also address the underlying cause of HH by treating tumors and adjusting medication that may be suppressing your hormones.
Preventing Hypogonadism
Secondary hypogonadism can’t always be prevented, but you can take these steps to lower your risk:
Avoid Injury
Protect your brain from injury. Wear a helmet during activities like biking and football.
Don’t Abuse Drugs
Don’t use recreational drugs. Use prescription medication under your physician’s supervision.
Manage Stress
Get help managing stress. Talking to a therapist can improve your emotional outlook.
Watch Your Diet and Weight
Eat a balanced diet and maintain a healthy weight to support your body’s natural functions.
Up to
10 in 100KBabies are born with hypogonadotropic hypogonadism.
Source: National Institutes of Health, National Library of Medicine: Hypogonadotropic Hypogonadism Revisited
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