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Hypothalamic hypogonadism is a medical condition characterized by the underproduction of hormones by the hypothalamus, a region of the brain that controls the pituitary gland. The hypothalamus produces gonadotropin-releasing hormone (GnRH), which stimulates the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). These hormones, in turn, signal the testes in males and ovaries in females to produce sex hormones like testosterone and estrogen, respectively, and to produce eggs and sperm.

When the hypothalamus does not produce enough GnRH, the pituitary gland is not adequately stimulated, leading to insufficient LH and FSH production. This deficiency results in low levels of sex hormones, which can affect sexual development and reproductive function. In children, hypothalamic hypogonadism can lead to delayed or absent puberty, with underdeveloped secondary sexual characteristics. In adults, it can cause infertility, decreased libido, fatigue, and mood changes.

The causes of hypothalamic hypogonadism are varied and can include genetic disorders, such as Kallmann syndrome, which is characterized by a lack of GnRH production and a diminished sense of smell. Other causes can be acquired, including tumors in the brain, head trauma, radiation therapy, certain medications, and chronic illnesses. Lifestyle factors like extreme exercise, malnutrition, and significant stress can also temporarily suppress GnRH production. Diagnosis typically involves blood tests to measure hormone levels, along with imaging studies like MRI scans of the brain. Treatment often involves hormone replacement therapy to restore adequate sex hormone levels and promote normal sexual development and function.