Hypogonadotropic Hypogonadism in Empty Sella Syndrome: 
A Case Report and Review of the Literature

Adib, Ehsan; Zakeri, Anahita; Banaei, Shokofeh

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Hypogonadotropic Hypogonadism in Empty Sella Syndrome: A Case Report and Review of the Literature

Ehsan Adib

, Anahita Zakeri

, Shokofeh Banaei ^*

Department of Physiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran , S.banaei@arums.ac.ir

Abstract: (14 Views)

Background: Hypogonadotropic hypogonadism occurs when the pituitary gland fails to synthesize sufficient amounts of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In this deficiency, despite the normal testicular parenchyma, testosterone production from the testicles is reduced, ultimately causing symptoms in the individual. An uncommon cause of inadequate secretion of LH and FSH is empty sella syndrome (ESS). This condition occurs when cerebrospinal fluid accumulates in the sella turcica for various reasons, leading to flattening of the pituitary gland.
Case Presentation: This case report introduces a 24-year-old man who complained of symptoms related to some secondary sexual characteristics compared to his peers, such as decreased libido. Investigations included brain MRI and hormonal tests, which revealed empty sella as well as decreased testosterone, LH, and FSH levels.
Conclusion: After the definitive diagnosis of ESS, treatment with human chorionic gonadotropin (hCG) was started for the patient. However, after some time, the patient faced challenges in his treatment and gave up on continuing the treatment.

Keywords: Empty Sella Syndrome, Hypogonadotropic, Hypogonadism, Pituitary Gland

Full-Text [PDF 535 kb] (12 Downloads)

Type of Study: case report | Subject: Endocrine diseases
Received: 2025/10/5 | Accepted: 2025/11/15

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