What causes hypogonadism in males?

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varicocele — reproductive system disease Varicocele, enlargement of the veins of the spermatic cord, is a cause of infertility in men.

In males, hypogonadism is characterized by decreased testicular function, leading to testosterone deficiency and infertility. The condition arises from three primary categories of disease:

Hypothalamic and Pituitary Disorders

These conditions disrupt the hormonal signaling required for testicular function. Causes include:
* Tumors and cysts of the hypothalamus or pituitary gland.
* Trauma, hemochromatosis, and infections.
* Chronic illness and malnutrition.

Testicular Disorders

These involve direct damage or developmental issues within the testes:
* Chromosomal disorders: Such as Klinefelter syndrome.
* Inflammation: Specifically orchitis caused by mumps.
* Environmental and Chemical Exposure: Exposure to gonadal toxins—including alcohol, marijuana, and certain anticancer drugs—as well as X-ray radiation.

Many of these conditions may present as delayed puberty or remain mild enough that they are not identified until adulthood when fertility issues or other symptoms arise.1