Male hypogonadism (small genitals in males): Causes, Symptoms and Treatment

Male hypogonadism is a condition in which there is an underproduction of sperm or testosterone, or both, by the testes. A person may be born with hypogonadism, or it can occur later in life due to some injury or infection. Symptoms and treatment of hypogonadism depend on the cause and time of occurrence.

Male hypogonadism

Male hypogonadism causes and risk factors


Low testosterone level can be caused by:

  • Injury to the testes (trauma, radiation, castration or chemotherapy)
  • Tumour or disease of pituitary or hypothalamus
  • Mumps infection involving the testicles
  • Certain inflammatory diseases like sarcoidosis, histiocytosis and tuberculosis
  • Obesity
  • Certain medications such as corticosteroids or opiate painkillers
  • Genetic conditions like Klinefelter syndrome, Kallmann syndrome and Prader-Willi syndrome

Male hypogonadism symptoms

  • Incomplete development of male genitals
  • Lack of deepening of voice in puberty
  • Reduced sexual desire and activity
  • Decreased spontaneous erections
  • Breast enlargement or discomfort
  • Impaired growth of testes or penis
  • Loss of bone mass
  • Loss of body hair
  • Reduced muscle volume and strength
  • Low to zero sperm count
  • Decreased energy levels and fatigue
  • Mild to moderate depression

Male hypogonadism diagnosis

First, the doctor does a physical examination to know whether your sexual development like pubic hair, muscle mass and size of penis and testes is appropriate for your age or not.

Then, a blood test is done to determine the level of testosterone in the blood. To diagnose it as low testosterone level a male needs to get more than one early morning blood test done. If testosterone level is repeatedly low, then other tests like pituitary gland function test, semen analysis and testicular biopsy are done to check other factors.

Male hypogonadism treatment and prevention


Hormone therapy: Testosterone replacement therapy (TRT) is given for treating hypogonadism caused by the testicular failure. TRT can restore sexual function and muscle mass and prevent bone loss. In young boys, TRT can stimulate puberty and the development of beard, pubic hair and penis.

There are several ways in which TRT is done:

  • Injections to muscle
  • Patches applied to skin
  • Gel or solutions applied to skin
  • Buccal tablets
  • Pellets implanted under the skin

The way TRT is given depends on the patient’s preference and tolerance.

Assisted reproduction: There are no effective treatments to restore fertility in men with hypogonadism due to problems of testicles. Therefore, assisted reproductive technology may be helpful for them.

Male hypogonadism read more


Complications of hypogonadism are different in different ages, like:

During fetal development

A baby may have

  • Ambiguous genitalia
  • Abnormal genitalia

During puberty

  • Lack of beard or body hair
  • Impaired penis and testicle growth
  • Enlarged male breasts (gynecomastia)

In adults

  • Infertility
  • Erectile dysfunction
  • Fatigue
  • Low sex drive
  • Muscle loss
  • Gynecomastia
  • Osteoporosis

 Next Steps

Visit your doctor if you experience any symptoms of male hypogonadism.

Consult a top Urologist

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  • Hypogonadism. Available at  http://www.hormone.org/diseases-and-conditions/mens-health/hypogonadism. Accessed on 17th August 2016
  • Male Hypogonadism. Available at  http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/male-hypogonadism/. Accessed on 17th August 2016

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