“In this world nothing can be said to be certain, except death and taxes.”

—Benjamin Franklin

Today we know there is one more thing that is for certain…hypogonadism.

Information on hypogonadism for women and men of all ages

The illness, hypogonadism, (hi-PO-go-nad-ism) will happen to every human, being usually beginning around age 30 years. The word hypogonadism comes from two words, the first, ‘hypo’ meaning low and the second word, ‘gonad’ meaning ovary or testicle. The gonads of women and men produce the same sex hormones, just in different quantities. The sex hormones are progesterone, testosterone, DHEA and estradiol.

Eventually, like every other organ in the body, the gonads will begin to fail and will produce lower than normal amounts of each sex hormone. The treatment and symptoms of hypogonadism are the same for women and men. The reason the symptoms are the same is because the sex hormones do the same thing in both women and men. For instance, if a woman is low on testosterone her symptoms will be the same as a man who is low on testosterone, lack of energy, lack of clitoral erection (low or no arousal), fuzzy thinking, constipation, and muscle loss. The sex hormones are human hormones and work the same way in every human being.

Hypogonadism advances differently in women and men

Women advance through the stages of hypogonadism faster than men because their gonads (ovaries) fail sooner. Mild to moderate hypogonadism (Stages 1 and 2) is called peri-menopause (between ages 30-45 years) and advanced hypogonadism (stage 3) is called menopause (begins about age 45 years). Notice that advanced hypogonadism begins before the ovaries have completely run out of eggs and fail around the ages of 46-51. The transition from peri-menopause to menopause is the progression of hypogonadism from mild to advanced.

For men, hypogonadism usually advances more slowly. Mild to moderate hypogonadism (stages 1-2) usually occurs between the ages of 30-55 years. Advanced hypogonadism (stage 3) usually occurs by age 55-60 years and older. For men, all stages of hypogonadism are usually referred to as hypogonadism, low testosterone, low T, or low sex hormones.

Hypogonadism is a real illness with real consequences

Hypogonadism is not benign in men or women at any age. Unfortunately for women, hypogonadism is referred to as a natural, expected decline in health which should not be treated. That is folklore and wrong. Hypogonadism is real. It is very unhealthy. It will continue to take a toll on a woman’s health the same as it will on a man’s, whether you feel it or not. Not treating it ensures poorer health.

Since hypogonadism consists of multiple hormone deficiencies the way to treat it is to restore each of the sex hormones to normal levels. Like all other hormone deficient illnesses, if done correctly, treatment is lifelong and healthy. Not everyone will agree that hypogonadism should be treated in women and men however, we can all agree on the following:

Normal hormone levels are always healthier

Abnormal hormone levels are always unhealthier

Discrimination in clinical research trials contributes to a lack of treatment opportunities for women

Effective treatment of hypogonadism in women and men is simple, straightforward, and powerful. Even so, women are routinely steered away from treatment while men are routinely encouraged to receive treatment, albeit sometimes incomplete treatment. Unfortunately, there is a bias woven into women’s clinical trials which ensures their failure. Failure of a clinical trial means the treatment is worse than the illness. Hence, treatment is discouraged. Without discrimination clinical trials could be successful. Over nearly 100 years of clinical trials, hormone levels in women have never been tested. No measurement means no adjustments means no success means no options. The reason for not measuring is because replacement and success could not have been the goals. This is key to understanding why these clinical trials have consistently failed.

It’s different for men. Clinical trials measure hormone levels before and after hormone medication is given and adjust levels as necessary. Men’s trials use modern medicine and modern technology. Still there is room for improvement. Clinical trials for men typically only measure one of the sex hormones, testosterone. For trials to be successful all the sex hormones (progesterone, testosterone, DHEA and estradiol ) have to be measured and adjusted to normal levels, not just one.

Discrimination robs women of their wellbeing and their fertility.

Without effective treatment or limited access to treatment women will continue to unnecessarily suffer the ill health of hypogonadism. Hypogonadism puts an unnecessary strain on the gonads (ovaries) of women which impairs fertility. This unnecessary strain causes the ovaries to work harder than they have to, which accelerates the usage of a finite supply of eggs, which in turn causes an accelerated depletion of the ovaries. At the same time an accelerated usage causes an acceleration of egg maturation which means an increase in birth defects. If hypogonadism is treated early it is likely that birth defects would be reduced. If hypogonadism is treated early enough the ovaries would not have to recruit extra eggs and deplete their supply so quickly. Treatment of hypogonadism should extend fertility and ovarian function by years.

With dysfunction in the gonads (peri-menopause) a woman’s health declines. Over time hypogonadism will advance and become more severe. Left untreated long enough hypogonadism will have a profoundly negative impact on sleep, cognitive function, energy, sexual response, and relationships.

Isn’t hypogonadism and its advanced form, profound hypogonadism, simply a rite of passage for women?

Absolutely not. Hypogonadism is a real illness and treatable in both men and women. Proper treatment could mean that fertility may be prolonged and may reduce birth defects. Proper treatment means protecting oneself from breast cancer and ovarian cancer. Proper treatment means preserving sexual function, sleep, brain function, mood, and absorption of nutrients.

Proper treatment means the difference between being healthy and not being healthy.

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