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Causes of primary hypogonadism include: Aging (with significant declines in testosterone production after age 50) Alcohol abuse (which can directly damage the testicles) Autoimmune diseases (like autoimmune orchitis in males or autoimmune oophoritis in females) Cryptorchidism (undescended testicles) Genetic disorders (like Klinefelter syndrome in males and Turner syndrome in females) Hematochromatosis (an overload of iron that can lead to testicular or ovarian failure) Infections (like mumps orchitis in males or pelvic inflammatory disease in females) Polycystic ovary disease (PCOS) / polyendocrine metabolic ovarian syndrome (PMOS) Testicular or pelvic radiation Testicular or ovarian injury Causes of secondary hypogonadism include: Alcohol abuse (which can impair the pituitary gland or hypothalamus) Brain surgery or radiation Genetic disorders (like Kallmann syndrome or Prader-Willi syndrome, which can affect the hypothalamus) Medications (including opioids, corticosteroids, antidepressants, and chemotherapy) Obesity (which affects signaling between the hypothalamus and pituitary gland) Pituitary or hypothalamus tumors Systemic infections (like HIV, sarcoidosis, or tuberculosis) Traumatic brain injury What Is Testosterone