The key difference between primary and secondary hypogonadism is that primary hypogonadism is a type of male hypogonadism that originates due to a problem in the testicles, while secondary hypogonadism is a type of male hypogonadism that originates due to a problem in the hypothalamus or pituitary gland.
Male hypogonadism arises when the testicles do not produce enough of the male sex hormone “testosterone.” This hormone plays a vital role in masculine growth and development during puberty or making enough sperms. People can be born with male hypogonadism, or they can develop this condition later in life due to injury or infection. There are two basic types of male hypogonadism as primary and secondary hypogonadism.
CONTENTS
1. Overview and Key Difference
2. What is Primary Hypogonadism
3. What is Secondary Hypogonadism
4. Similarities – Primary and Secondary Hypogonadism
5. Primary vs Secondary Hypogonadism in Tabular Form
6. Summary – Primary vs Secondary Hypogonadism
What is Primary Hypogonadism?
Primary hypogonadism is a type of male hypogonadism that originates due to a problem in the testicles. It is also known as primary testicular failure. The causes of primary hypogonadism include autoimmune diseases like Addison’s diseases and hypoparathyroidism, genetic disorders like Turner syndrome and Klinefelter syndrome, and severe infections that especially involve testicles (mumps), liver and kidney injury, undescended testes, hemochromatosis, radiation exposure, and surgery on the sexual organs.
A patient may be diagnosed with primary hypogonadism if the serum testosterone concentration and the sperm count are below the normal and the serum LH and FSH concentrations are above the normal. The symptoms associated with this condition are female genitals, genitals that are neither clearly male nor clearly female, underdeveloped male genitals, hampered development of muscle mass, voice deepening, growth and facial hair, growth of the penis, excessive growth of the arms and legs in relation to the trunks, development of breast tissue, decreased sex drive, depression, erectile dysfunction, infertility, loss of bone mass, difficulty concentrating, and hot flashes.
Figure 01: Genetic and Molecular Basis of Idiopathic Hypogonadotropic Hypogonadism
This medical condition can be diagnosed through hormone testing, semen analysis, genetic testing, and testicular biopsy. Furthermore, the treatment options for primary hypogonadism may include testosterone hormone replacement therapy (giving testosterone through the gel, injection, patch, gum and cheek, nasal or implantable pellets), and assisted reproductive technology.
What is Secondary Hypogonadism?
Secondary hypogonadism is a type of male hypogonadism that originates due to a problem in the hypothalamus or pituitary gland. It is also known as central hypogonadism. The common symptoms may include decreased libido or associated decrease in erectile sexual activity, a decreased sense of vitality, decreased strength, and some degree of problems with bone mineral density or cognition. The causes of secondary hypogonadism include Kallmann’s syndrome, pituitary disorders, inflammatory diseases, HIV/AIDS, medications (pain medications and some hormones), obesity, and aging. Moreover, the patient may experience secondary hypogonadism if the serum testosterone concentration and the sperm count are subnormal and serum LH and FSH concentrations are not elevated.
This medical condition can be diagnosed through hormone testing, semen analysis, and pituitary imaging. Furthermore, treatment options may include testosterone hormone replacement therapy, pituitary hormones given to stimulate sperm production, and restoring fertility. If the problem is due to a pituitary tumor, it requires surgical removal, medication, radiation, or the replacement of other hormones.
What are the Similarities Between Primary and Secondary Hypogonadism?
- Primary and secondary hypogonadism are two basic types of male hypogonadism.
- Both medical conditions have similar symptoms.
- Both medical conditions may have a genetic predisposition.
- They are treated by testosterone replacement therapy.
What is the Difference Between Primary and Secondary Hypogonadism?
Primary hypogonadism is a type of male hypogonadism that originates due to a problem in the testicles, while secondary hypogonadism is a type of male hypogonadism that originates due to a problem in the hypothalamus or pituitary gland. Thus, this is the key difference between primary and secondary hypogonadism. Furthermore, a patient has primary hypogonadism if the serum testosterone concentration and the sperm count are below normal and the serum LH and FSH concentrations are above normal. On the other hand, a patient has secondary hypogonadism if the serum testosterone concentration and the sperm count are subnormal and serum LH and FSH concentrations are not elevated.
The below infographic presents the differences between primary and secondary hypogonadism in tabular form for side by side comparison.
Summary – Primary vs Secondary Hypogonadism
Male hypogonadism is a condition in which testicles do not produce enough testosterone. There are two types of male hypogonadism as primary and secondary hypogonadism. Primary hypogonadism originates due to a problem in the testicles. Secondary hypogonadism originates due to a problem in the hypothalamus or pituitary gland. So, this is the difference between primary and secondary hypogonadism.
Reference:
1. Martel, Janelle. “Hypogonadism: Types, Causes & Symptoms.” Healthline, Healthline Media, 2 June 2018.
2. “Male Hypogonadism.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Sept. 2021.
Image Courtesy:
1. “The genetic and molecular basis of idiopathic hypogonadotropic hypogonadism” By Suzy D. C. Bianco and Ursula B. Kaiser; Nature Reviews Endocrinology 5, 569-576 (October 2009)doi:10.1038/nrendo.2009.177 (CC BY-SA 4.0) via Commons Wikimedia