Hypogonadotropic Hypogonadism (HH)

Definition - What does Hypogonadotropic Hypogonadism (HH) mean?

Hypogonadism is a condition in which the ovaries or testes produce little or no sex hormones. In hypogonadotropic hypogonadism (HH), there is an underlying problem with the hypothalamus or pituitary gland that leads to the condition of hypogonadism. HH results in infertility in both men and women.

The hypothalamus is a brain region that controls the body's maintenance of equilibrium states and basic drives such as hunger, thirst, and sleep, and governs the pituitary gland by secreting gonadotropin releasing hormone (GnRH). The pituitary gland, in turn, secretes follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones then stimulate the ovaries or testes to produce sex hormones. A number of genetic and environmental factors can lead to a problem with this chain of signals to produce the condition of hypogonadotropic hypogonadism.

FertilitySmarts explains Hypogonadotropic Hypogonadism (HH)

Primary hypogonadotropic hypogonadism (HH) is due to rare conditions a person is born with. Primary HH results in a failure to undergo sexual development upon reaching the age of puberty. Kallmann Syndrome is an example of inherited primary HH. (One possible additional symptom of Kallmann Syndrome is an impaired sense of smell.)

Secondary HH is acquired later in life due to environmental factors. Anything that damages the hypothalamus or pituitary gland may cause this condition, including:

  • Tumors
  • Physical injuries
  • Infections
  • Specific drugs or radiation
  • Eating disorders
  • Excessive exercise
  • Extreme stress

HH can be treated by administering the missing hormones at any point along the chain from hypothalamus to pituitary to ovaries or testes. So, for example, in patients with a functional pituitary gland, HH may be treated by administering the missing gonadotropin releasing hormone (GnRH) that the hypothalamus should have been producing, which then causes the pituitary gland to produce the hormones that in turn cause the ovaries or testes to begin producing sex hormones normally. If it is the pituitary gland that is not producing its hormones (FSH and LH), these hormones can be supplied and will result in the ovaries and testes producing their sex hormones.

Finally, HH may be treated by directly administering the appropriate sex hormones (testosterone in males, and estrogen and progesterone in females). Choice of appropriate treatment depends upon the patient, hormone availability, and cost. Proper treatment has a high chance of restoring fertility.

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