Hypogonadotropic / Secondary (Low LH, FSH, low T, E) - Hypothalamic

• Neoplastic
  • Anterior Pituitary Diseases
    • Second (LH) and third (FSH) most likely hypo-functional tumor
  • Hyperprolactinemia ↑ → Galactorrhea
    • Due to inhibitory of prolactin effect on GnRH
• Congenital
  • Kallman’s Syndrome
• Trauma
  • TBI
  • Radiation Therapy
  • Sheehan’s syndrome
• Drugs
  • Opioid (Narcotics)
  • AAS - Anabolic-Androgenic Steroid (anabolic)
  • Oral Corticosteroid (OCS)
  • Alcohol (RF)
  • Cannabis
• Infiltrative
  • Hemachromatosis
• Psychiatric
  • Anorexia (loss of appetite)
• Others
  • Sleep disorders
  • Severe Obesity
  • Comorbidity illness of aging
• Idiopathic