Hypogonadotropic hypogonadism (HH, gonadotropin-releasing hormone deficiency) is a congenital or acquired condition defined by abnormal ovarian or testicular function due to decreased secretion of gonadotropins resulting from pituitary or hypothalamic gland dysfunction. HH is caused by gonadotropin-releasing hormone (GnRH), follicle stimulating hormone (FSH), and luteinizing hormone (LH) deficiencies. Some causes include genetic diseases (eg, Kallmann syndrome); damage to the pituitary gland or hypothalamus due to injury, surgery, tumor, infection, or radiation; usage of opioid or steroid drugs for an extended period of time; severe stress; nutritional deficiencies; and chronic medical diseases (eg, chronic inflammation or infection.

Females – Typically, a female child presenting with HH experiences a lack of development at puberty; breasts will not develop properly and menstruation will not occur. Female adult-onset patients may experience loss of menstrual periods. Treatment is dependent on the cause. Options for female patients include estrogen and progesterone pills or skin patches and GnRH injection.

Males – Typically, a male child presenting with HH will not experience deepening of voice, increase in facial hair, and enlargement of testes and penis during puberty. Male adult-onset patients may present with loss of libido and loss of muscle mass. Treatment is dependent on the cause. Options for male patients include testosterone injections, oral capsules, patches, or gels and GnRH injections.

Potential complications include delayed puberty, early menopause, infertility, low libido, and low bone density and a predisposition to fractures. Adolescents may suffer from low self-esteem due to delayed puberty.

Some hormonal treatments will prompt puberty and restore fertility. If HH begins after puberty, symptoms may improve with treatment.