I've read about secondary hypogonadism. And I think I have an idea why. See under times of stress GNRH production in the brain is reduced. What happens is that as cortisol( autochthonous glucorticoids) increases... the body releases GnIH. It's a survival mechanisms as cortisol is needed for the bodys function, under stress. Once threat, disease state or general threat state ends. Cortisol goes down and stops mediating GnIH(Which was recently discovered in birds). GnIH, is sort of a switch off, of fertility hormones like lutenizing hormone and follicle stimulating hormone. Which are essential for fertility and sexuality. My idea is that otherwise healthy men, who experience, depression, poor sleep(insomnia), sleep deprivation, poor nutrition, obesity, overtraining, basically being in a state of chronic stress. Put themselves at risk of GnIH production being stuck in the GnIH loop. So instead of the body returning to normalize GNRH production. The body continues producing GnIH, even after. The feedback loop itself is stuck rather than damaged. Which is why on MRIs the hypothalamus/Pituary glands look completely undamaged. What happens isn't actual damage to the structure of those glands. But rather like throwing a monkey wrench inside of the structure. The only way to actually see hypogonadism in this case, would be to actually look into the glands activities, which MRI's can't do on a microlevel.
The other reason is pituary. GNRH fails to stimulate the pituary gland.
Inflammatory conditions can also risk creating similar problems, by chronically adding potent glucortecorteroids to the body. So while asthma meds/inflammatory meds help with regulating a inflammatory condition, you create artificial stress in body. Inflammatory conditions are caused by lack of equilibrium of Homocysteine. Which is created by having an incomplete immune system, plus disorder susceptibilities. By adding the artificial stress response, you're not actually addressing the problem. You're just creating artificial stress modulation. You're not restoring the immune system imbalance.
Samething with TRT/HRT. You're not addressing the underlying issue. You're just replacing the capacity for production that is lost. Which Is understandable.. since the technology necessary doesn't exist yet. My hope is that somehow stemcells can act by replacing or inducing damaged or malfunctioning cells in the hypothalamus and pituary glands to start producing GNRH.
What is the loop? I'm seeing how stress means increased cortisol, which means increased GnIH, which means lower testosterone. Okay, good. But I see no loop in this? I only see the power of chronic stressors, which in the case of depression are sometimes external (i.e., adaptive in that a person is depressed because of stuff happening around him, e.g., someone very close dies), but for the vast majority of the time (especially with recurring depression) are internal, mediated by cognitions (thoughts, beliefs), in that a person is *really* depressed because (as Sapolsky says) the cerebral cortex (advanced thinking, meaning) is feeding false information (thoughts, beliefs) that are stressful in content to the limbic system (emotion).
I think it would be more precise to say that people with a tendency toward depression have:
1) a genetic or environmental influence toward a deficiency with cortisol (which is essential because it *tones down* the more primary norepinephrine release, which causes the brain to release CRH to the pituitary, which releases ACTH, which in turn releases more norepinephrine, epinephrine, cortisol, and other adrenal hormones such as DHEA, pregnenolone, etc., and then the cortisol is used to "tell" the hypothalamus to tone it down on CRH --> less ACTH --> less adrenal hormones),
2) a deficiency (again genetic or environmental) with testosterone (which means higher cortisol because cortisol is inversely related to T, and therefore presumably higher epinephrine/norepinephrine because these latter hormones coincide with the release of cortisol in the adrenals),
3) a chronic stress situation that involves an adaptive depression and therefore *isn't* affected by magnified cognitions causing more depression than "necessary" (hence more norepinephrine --> higher CRH, ACTH, adrenal hormones including epi/norepi, cortisol, etc.), and/or
4) a chronic internalization of stress in terms of distorted thinking (which means the cortex is feeding the limbic system more "lies" which the limbic system knows no better about and still gets stressed over, meaning more norepinephrine to start the increase in CRH --> high ACTH, adrenal hormones, higher cortisol, and so on in proportion to [and as long as the continuation of] the original release of norepinephrine from the falsely perceived stressful event because of bad cognitions).