Hypogonadism in men

May present with features of testosterone deficiency and/or infertility.

When caused by pituitary macro-adenoma, patients may have additional symptoms due to mass effects, such as headaches or peripheral visual disturbance. There may also be signs and symptoms of other pituitary hormone deficiencies.

Early morning serum total testosterone level below 10.4 nanomol/L (<300 nanograms/dL) on at least two separate occasions in a symptomatic man generally confers the diagnosis of hypogonadism.

Testosterone should be measured in all men with erectile dysfunction.

Measurement of the gonadotrophins (LH and FSH) distinguishes between a primary and a secondary cause.

The aim of testosterone therapy is to achieve serum testosterone levels within the normal physiological range with dose adjustment to have the maximum effect on alleviation of symptoms.

Hypogonadism in males is a clinical syndrome that comprises symptoms and/or signs, along with biochemical evidence of testosterone deficiency.[1]Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA Guideline. J Urol. 2018 Mar 28. pii: S0022-5347(18)42817-0. [Epub ahead of print] https://www.auanet.org/guidelines/evaluation-and-management-of-testosterone-deficiency http://www.ncbi.nlm.nih.gov/pubmed/29601923?tool=bestpractice.com

The male gonads (testes) have 2 primary functions: testosterone production (by the Leydig cells) and spermatogenesis (by the spermatogenic and Sertoli cells in the seminiferous tubules). Hypogonadism in men occurs where there is dysfunction in the normal physiological mechanism of the hypothalamic-pituitary-gonadal axis that results in a decreased ability to carry out either of these functions.