Sperm development (spermatogenesis) and release of the egg from the ovaries (ovulation) may be impaired by hypogonadism, which, depending on the degree of severity, may result in partial or complete infertility.
[1][2] Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e.g., premature menopause) in adults.
[citation needed] Women with hypogonadism do not begin menstruating and it may affect their height and breast development.
Onset in women after puberty causes cessation of menstruation, lowered libido, loss of body hair, and hot flashes.
In men, it causes impaired muscle and body hair development, gynecomastia, decreased height, erectile dysfunction, and sexual difficulties.
[citation needed] Testing serum LH and FSH levels are often used to assess hypogonadism in women, particularly when menopause is believed to be happening.
[8] Low testosterone can be identified through a simple blood test performed by a laboratory, ordered by a health care provider.
[9][10] Normal total testosterone levels depend on the man's age but generally range from 240 to 950 ng/dL (nanograms per deciliter) or 8.3–32.9 nmol/L (nanomoles per liter).
[15] A position statement by the Endocrine Society expressed dissatisfaction with most assays for total, free, and bioavailable testosterone.
[17] Measurement by equilibrium dialysis or mass spectroscopy is generally required for accurate results, particularly for free testosterone which is normally present in very small concentrations.
It is particularly indicated in men with hypogonadism who wish to retain their fertility, as it does not suppress spermatogenesis (sperm production) as testosterone replacement therapy does.
[citation needed] For both men and women, an alternative to testosterone replacement is low-dose clomifene treatment, which can stimulate the body to naturally increase hormone levels while avoiding infertility and other side effects that can result from direct hormone replacement therapy.