The hypothalamus releases gonadotropin-releasing hormone (GnRH) to stimulate the pituitary gland. The pituitary gland releases luteinizing hormone (LH) and follicle-stimulating hormone (FSH). LH and FSH stimulate the Leydig cells in the testes to produce testosterone. Testosterone gets released into the bloodstream where it binds to sex hormone-binding globulin (SHBG) and albumin or remains in its free form to find other targeted cells to bind with.
The system is regulated by the hypothalamic-pituitary-testicular-axis (HPTA) which is sometimes referred to as the hypothalamic-pituitary-gonadal-axis (HPGA).
Stems from defects in the gonads as observed through elevated levels of LH and FSH; suggesting that the gonads aren't receiving the pituitary's signal to produce testosterone.
Stems from defects of the hypothalamus or pituitary gland as observed through reduced or normal levels of LH and FSH; suggesting that the problem of low testosterone stems from the HPTA/HPGA.
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