Pediatric hypogonadism

What is pediatric hypogonadism?

Hypogonadism (hy·​po·​go·​nad·​ism) or gonad deficiency occurs when the sex glands produce little or no sex hormones. Sex glands or gonads are ovaries in girls and testes in boys.

What are the different types of pediatric hypogonadism?

• Primary hypogonadism is when there not enough sex hormones are produced in body. The message from the brain to the gonads is received but they are not able to produce them.

• Secondary or central hypogonadism occurs when there is a problem with the pituitary gland in the brain and the messages to produce the hormone aren’t working.

What are the signs and symptoms of pediatric hypogonadism?

In girls, hypogonadism will affect breast development and height. There may be a delay in beginning menstruation.

If hypogonadism occurs after puberty, symptoms include:

• Hot flashes

• Loss of body hair

• Cessation of menstruation

• Milky discharge from breasts

In boys, hypogonadism will most often be manifested as less than normal muscle development, very little or no facial hair and growth problems.

After puberty, symptoms include:

• Breast enlargement

• Decreased facial and body hair

• Difficulty concentrating

• Infertility

• Fatigue

• Hot flashes

• Muscle loss

• Sexual problems

What are the causes of pediatric hypogonadism?

Primary hypogonadism causes include:

• Autoimmune disorders such as Addison's disease

• Certain disorders where the body mistakenly attacks healthy tissue

• Genetic and developmental disorders

• Infection

• Liver and kidney disease

• Radiation exposure

• Surgery on sex organs

• Undescended testes (UDT)

Secondary or central hypogonadism causes include:

• Bleeding

• Certain medicines, including steroids and opiates

• Genetic problems

• Infections such as HIV and AIDS

• Inflammatory diseases such as sarcoidosis, tuberculosis and histiocytosis

• Nutritional deficiencies

• Obesity

• Radiation exposure

• Rapid, significant weight loss

• Surgery

• Trauma

• Tumor in or near the pituitary gland

How is pediatric hypogonadism treated?

• Treatment for girls - Hormone replacement is also widely prescribed for girls with hypogonadism. Estrogen and progesterone are usually given together.

• Treatment for boys - Testosterone replacement therapy can trigger puberty and start the development of increased muscle mass, facial and pubic hair and growth of the penis. Pituitary hormones may be prescribed to stimulate testicular growth.