What is Hypogenitalism?

Hypogenitalism represents an underdevelopment of the sexual organs. This includes both the primary and secondary sexual characteristics. Possible causes are a lack of production of sex hormones and their insufficient effectiveness.

What is hypogenitalism?

Hypogenitalism is the insufficient development of the primary and secondary sexual characteristics. The underdevelopment of the external genitalia is in the foreground. See AbbreviationFinder for abbreviations related to Hypogenitalism.

Hypogenitalism is the insufficient development of the primary and secondary sexual characteristics. The underdevelopment of the external genitalia is in the foreground. In men, only a small penis develops. The scrotum is usually small and smooth. In extreme cases, there is even only a micropenis. In women, the fallopian tubes and uterus are not fully developed.

Both sexes also show incomplete secondary sexual characteristics. Hypogenitalism and hypogonadism are closely related. The two terms should not be confused with one another. Hypogonadism is the underfunction of the gonads such as testicles or ovaries, whereby too few sex hormones are produced. The lack of sex hormones causes the underdevelopment of the sex organs (hypogenitalism).

However, hypogenitalism can also have other causes. In some cases, the effectiveness of the sex hormones is reduced despite normal hormone concentrations.


There are many causes of hypogenitalism. It should be noted that underdevelopment of the sex organs is not an independent disease, but only a symptom of an underlying disorder or disease. There is often a genetic cause. Various syndromes such as Klinefelter syndrome, Turner syndrome, Kallmann syndrome, Prader-Willi syndrome or Laurence-Moon-Biedl-Bardet syndrome also have hypogenitalism as a symptom.

At least twenty different diseases or syndromes can lead to a disorder of genital development. Most of these diseases are genetic. They often lead to a lack of hormone production via hypogonadism. In pseudohermaphroditism feminus, however, there is a male genotype XY with sufficient production of testosterone. However, due to ineffective receptors for testosterone, it cannot develop its effectiveness.

The affected person is phenotypically female without having functional female gonads. In some cases, however, male and female sex characteristics are equally present. This is called hermaphroditism (hermaphrodite).

However, hypogenitalism can also be idiopathic. Here there is an isolated underdevelopment of the genitals without any recognizable cause. It is possible that the boundary between normal and pathological genitalia size is often blurred here due to the imprecise definition.

As mentioned earlier, hypogenitalism is just a symptom of an underlying disorder. In men, it manifests itself in a small childlike penis, which does not develop further even after puberty. We speak of a micropenis when it does not exceed a length of seven cm when erect. In addition, the prostate can hardly be felt. Sometimes only a hazelnut-sized lump is palpable. In women, the uterus and fallopian tubes are underdeveloped. The secondary sexual characteristics are insufficiently developed in both sexes.

Symptoms, Ailments & Signs

The additional symptoms depend on the underlying condition. If there is a testosterone deficiency, there are many other symptoms. The prerequisite for hypogenitalism is that the lack of testosterone occurs before puberty. Delayed puberty, small testicles, reduced fertility, muscle loss, female fat distribution, breast development, depression, other mental disorders and much more are evident.

Sometimes there is hypogenitalism without any additional symptoms. When a micropenis occurs, there is sometimes an intersexual disorder in which both male and female sexual characteristics are present. However, young people in particular often suffer from mental impairments. They often develop feelings of shame and shut themselves off from their peers.

In rare cases, they even develop anxiety disorders or depression. As a rule, those affected are not affected by the disorder in terms of their ability to have an erection or ejaculate. In most cases, a normal sex life is possible for the person concerned. Sometimes, however, positions and methods need to be adjusted accordingly. The fertility is also unrestricted.

Diagnosis & course of disease

To diagnose the underlying disorder in hypogenitalism, the concentration of the sex hormones is first determined. Depending on the symptoms that occur, genetic tests can still be carried out. The spectrum of possible syndromes is very large, so that differential diagnoses for different diseases are necessary.


Hypogenitalism primarily causes problems in the sexual organs and their underdevelopment. This can cause not only physical, but also psychological problems for the patient. In most cases, the amount of sex hormones in the patient is low, resulting in various behavioral and growth disorders.

Depression and other mental health problems are not uncommon. Those affected are often ashamed of the disease and its symptoms and thus suffer from an inferiority complex. The quality of life is also extremely limited by the disease. In most cases, hypogenitalism is treated with hormone therapy with no further complications.

If the symptoms do not go away, the underlying disease is diagnosed. Complications can occur if treatment is not initiated and muscle breakdown or anemia occurs. In severe cases, the patient may also become impotent.

However, if the hypogenitalism is only mildly pronounced, no treatment is necessary in most cases if the symptoms do not particularly bother the patient. Life expectancy is not reduced with early and correct treatment.

When should you go to the doctor?

If physical development delays occur in children during the transition to puberty, a check-up by a doctor should be carried out. A sudden premature stop in the development of the sex organs is also worrying. A reduced breast development or small testicles should be presented to a doctor and examined.

If there are menstrual problems, irregularities in menstrual bleeding or if there is no bleeding, a doctor should be consulted. In the case of sexual dysfunction, a loss of libido or visual abnormalities of the genitals, a doctor’s visit is necessary. Emotional problems, fear or shame should be discussed with a doctor or therapist. Depressive phases, a persistently depressed mood, behavioral problems or a loss of zest for life are signs where the person concerned needs help and support.

A change in personality is considered a cause for concern and needs to be evaluated by a doctor. Increased partnership conflicts, isolation or unusual social behavior should be clarified by a doctor. An unfulfilled desire to become pregnant, an incomprehensible loss of muscle mass or an unnatural distribution of fat on the body should lead to further medical examinations. It is necessary to clarify the cause so that no additional diseases develop or the quality of life of the person affected decreases. Nodules in the genitals should be examined and treated as soon as possible.

Treatment & Therapy

When hypogenitalism is caused by a lack of sex hormones, hormone therapy is an option. In male patients, testosterone can be administered via injections or in the form of testosterone patches. Women receive female sex hormones such as estradiol, ethinyl estradiol or the artificial sex hormone chlormadinone. The administration of the sex hormones causes a subsequent development of the primary and secondary sexual characteristics. However, it also depends on the underlying disease.

In Klinefelter syndrome, for example, there is a numerical chromosomal aberration in the sex chromosomes. This is the status XXY. They are male patients with a primary testosterone deficiency. Testosterone administration causes a clear improvement in the quality of life. In addition to the further development of the primary sexual characteristics, the hormone treatment also works against the existing anemia, muscle wasting, osteoporosis, impotence and depression.

Some disorders are also caused by the hormonal regulatory system. There is no isolated lack of sex hormones here. For example, the pituitary gland, the central endocrine organ, can be affected. In these cases, the cause must be identified and treated. Hormone replacement therapy, which includes other hormones, may also be necessary. However, hypogenitalism does not always require treatment.

In the case of idiopathic hypogenitalism, the question sometimes arises as to whether the size of the genital organ in this case is just outside the norm established by definition.


There is no way to prevent hypogenitalism. There are usually hormonal disorders, which are often genetic. In principle, more than twenty different diseases and syndromes can lead to underdevelopment of the sex organs.  Furthermore, it should also be noted that hypogenitalism is usually only a symptom of an underlying disease.


In the case of hypogenitalism, follow-up care in the medical sense is not necessary purely because of the weakly developed sexual organs. These do not require treatment, but can be stimulated to grow thanks to hormone therapy. This usually has to last a lifetime, which can result in regular check-ups and, if necessary, a discontinuation of therapy.

However, the many different clinical pictures and syndromes, which can be a symptom of hypogenitalism, can force follow-up care. Mention should be made, for example, of the necessary aftercare measures after an operation in people with trisomy 21, since organ malformations often occur here, or the aftercare measures in people with Prader-Willi syndrome. The latter often leads to diabetes and obesity with all its complications.

Hypogenitalism can also put a lot of psychological strain on those affected, which can even lead to self-injurious behavior. Mental illnesses and subsequent therapy sometimes make follow-up care in the form of further discussions or other therapies necessary.

Hypogonadism, which is very often the cause of hypogenitalism, is often associated with osteoporosis. From this increased risk of fractures, it can also be deduced that aftercare for fractures is relevant. However, this does not affect all people affected by hypogonadism.

You can do that yourself

The means of self-help are limited in hypogenitalism. Those affected are always dependent on a medical examination and therapy for this disease in order to overcome the symptoms of the disease.

The further treatment of hypogenitalism depends very much on the underlying disease, but is usually carried out with the help of hormones. In most cases, the symptoms are completely reduced by the medical treatment, so that the patients can lead a normal everyday life. Above all, early diagnosis of the disease leads to rapid treatment without complications. Those affected are only dependent on the regular intake of hormones. If the disease is diagnosed late, it can lead to disturbances in child development. These disorders must be compensated for by intensive therapy. Parents can often encourage their child accordingly in order to avoid problems in adulthood.

In the case of psychological complaints or inferiority complexes, talking to a psychologist or therapist can also help. Conversations with family members or friends are also suitable for this. Helpful information for everyday life can be collected through contact with other people affected by hypogenitalism.