CONCLUSION: Small genitalia, absent secondary sexual characteristics and infertility were the main presenting features of hypogonad men. Majority of patients had hypogonadotrophic hypogonadsim. [ncbi.nlm.nih.gov]

It must be emphasised that clinical guidelines present the best evidence available to the experts. However following guideline recommendations will not necessarily result in the best outcome. [uroweb.org]

A number of suggested thresholds have been published. (61,105) However, T assays produce highly variable results and treatment must be individualized based on a combination of clinical presentation and biochemical results. [nebido.com]

• Fatigue

  Symptoms associated with hypogonadism include reduced sex drive, fatigue, and mood disturbances, but accurate diagnosis requires biochemical testing. [ncbi.nlm.nih.gov]

• Anemia

  Signs of hypogonadism include (1) anemia; (2) muscle wasting (sarcopenia); (3) reduced bone mass or bone mineral density (BMD); (4) absence or regression of secondary sex characteristics; (5) abdominal adiposity (i.e. [medscape.com]

  Apart from reduced levels of testosterone, clinical hallmarks of hypogonadism include absence or regression of secondary sex characteristics, reduced fertility (oligospermia, azoospermia), anemia, muscle wasting, reduced bone mass (and bone mineral density [ncbi.nlm.nih.gov]

  The clinical features associated with true male hypogonadism are nonspecific and include impaired libido, erections, and fertility; reductions in lean muscle mass and bone density; loss of facial, axillary, and pubic hair; anemia; and changes in mood [jamanetwork.com]

  Third, many men with hypopituitarism have mild anemia due to testosterone deficiency. Other hormone deficiencies may contribute to the anemia. [pituitaryworldnews.com]

  […] dysfunction Decreased sense of well-being Depressed mood Difficulties with concentration and memory Fatigue Moodiness and irritability Loss of muscular strength Other changes that occur with low testosterone include: A decrease in hemoglobin and mild anemia [my.clevelandclinic.org]

• Increased Sweating

  […] body fat growth of breast tissue (gynaecomastia) thinning of the bones ( osteoporosis ) reduced muscle bulk and physical strength a wrinkled ‘parchment-like’ appearance of the skin increased sweating. [yourhormones.info]

• Decreased Muscle Mass

  Hypogonadism in Adult Men When hypogonadism occurs in grown men, it can impair normal reproductive function and can cause erectile dysfunction, infertility, decreased beard and body hair growth, decreased muscle mass, development of breast tissue, and [rejuvchip.com]

  The symptoms during pre-puberty include impaired growth of external male genitals, improper distribution of body hair, decreased muscle mass, gynecomastia or development of breast tissues, lack of deepening of the voice and disproportional growth of arms [uhs.ae]

  Finally, infertility, erectile dysfunction, decreased muscle mass and body hair, smaller testicles, gynecomastia, osteoporosis, mood changes, and decreased cognitive skills in adult men. [study.com]

• Headache

  In men the symptoms are: Breast enlargement Muscle loss Decreased interest in sex (low libido) If a pituitary or other brain tumor is present (central hypogonadism), there may be: Headaches or vision loss Milky breast discharge (from a prolactinoma) Symptoms [medlineplus.gov]

  Adverse effects associated with therapy include headache, hot flushes, insomnia, increased blood pressure, acne, emotional labiality, and nervousness. [ncbi.nlm.nih.gov]

• Sexual Dysfunction

  Low testosterone levels in these patients can be associated with loss of lean body mass and bone mass density, decline in mood, loss of energy, and sexual dysfunction. [ncbi.nlm.nih.gov]

  Symptoms of postpubertal hypogonadism include[1,2,3] (1) sexual dysfunction, such as reduced libido, erectile dysfunction (ED), diminished penile sensation, difficulty attaining orgasm, as well as reduced ejaculate with orgasm; (2) reduced energy, vitality [medscape.com]

  Later in life, this may result in reduced male fertility, sexual dysfunction, decreased muscle formation and bone mineralisation, disturbances of fat metabolism and cognitive dysfunction and may contribute to the development of testicular tumours. [uroweb.org]

• Hot Flushes

  Some patients, particularly those with partial androgen deficiency of the aging male, also experience sexual dysfunction, reduced sense of vitality, depressed mood, increased irritability, difficulty concentrating, and/or hot flushes in certain cases [ncbi.nlm.nih.gov]

  flushes in some cases of acute onset. [medscape.com]

  Sometimes affected individuals may experience emotional and mental disturbances, fatigue, loss of libido, hot flushes and lack of concentration. [uhs.ae]

  Vasomotor and nervous – Hot flushes – Sweating Androgen Deficiency Symptoms cont’d 12. – Diminished muscle mass – Loss of body hair – Abdominal obesity – Gynecomastia – Testes frequently normal, occasionally small Physical Signs Androgen Deficiency Symptoms [slideshare.net]

• Testicular Disease

  Hypogonadism may arise from testicular disease (primary hypogonadism) or dysfunction of the hypothalamic-pituitary unit (secondary hypogonadism). [ncbi.nlm.nih.gov]

  Classified as primary (resulting from testicular disease), secondary (resulting from pituitary and/or hypothalamic disease), or combined primary/secondary. -- To view the remaining sections of this topic, please sign in or purchase a subscription -- Last [hopkinsguides.com]

  disease.2-4 Controversy has arisen over the role of testosterone treatment in older men with medical comorbidities who have low levels of circulating testosterone, in the absence of hypothalamic, pituitary or testicular disease.5 There are gaps in the [mja.com.au]

  disease [ 79 ]) or testicular tumors with testosterone deficiency after treatment [ 80 ]. [intechopen.com]

[…] growth and maturation Testicular tissue testing: If the testes are not palpable and if it is not certain whether any testicular tissue is present, administering human chorionic gonadotropin (hCG) and measuring testosterone response may be helpful See Workup [emedicine.medscape.com]

Available online at https://emedicine.medscape.com/article/922038-workup#c6. Accessed March 2018. (Updated 2018 March). Male Hypogonadism. ARUP Laboratories. Available online at https://arupconsult.com/content/hypogonadism-male. Accessed March 2018. [labtestsonline.it]

This is also true in patients with an elevated prostate-specific antigen (PSA) >3 ng/mL, without further urologic workup.7 Goals of Therapy Goals of treating hypogonadal patients are focused around improvement of those symptoms, many of which can be achieved [uspharmacist.com]

[…] in testosterone that occurs in the afternoon.[ 4-6 ] Screening for hypogonadism in the general population is not indicated.[ 4 ] Case finding in selected circumstances is, however, acceptable, such as when testing for low testosterone is part of the workup [bcmj.org]

• Delayed Bone Age

  Delayed bone age (when maturity of the skeleton is behind for your age in years). [yourhormones.info]

• Testosterone Decreased

  As men age, there's a slow, progressive decrease in testosterone production. The rate varies greatly. [mayoclinic.org]

  As testosterone decreases, some men may experience symptoms similar to those of menopause in women. [fortishealthcare.com]

• Sperm Count Decreased

  Symptoms include low sperm count, decreased libido, erectile dysfunction, fatigue, sleep disturbances and depression. In primary hypogonadism, the testes fail to make testosterone because of infection or injury to the testes. [froedtert.com]

This article, Part 2, focuses on treatment and therapeutic considerations for male hypogonadism and identifies key questions for future research. [ncbi.nlm.nih.gov]

Prognosis Many forms of hypogonadism are potentially treatable and have a good prognosis. Prevention People should maintain normal body weight and have healthy eating habits to prevent anorexia nervosa. Other causes may not be preventable. [encyclopedia.com]

[…] testosterone – secondary or tertiary hypogonadism Prolactin Consider prolactin measurement in secondary hypogonadism Elevated prolactin should prompt evaluation of pituitary gland Associated testing – Endocrine Society recommends investigating causes/etiology [arupconsult.com]

Abstract and Etiology Abstract Male hypogonadism has a multifactorial etiology that includes genetic conditions, anatomic abnormalities, infection, tumor, and injury. [medscape.com]

[…] levels are variable based on presence of inhibin ↑ FSH if seminiferous tubule dysfunction is also present inhibin normally released by Sertoli cells to inhibit FSH if damaged that feedback is lost normal FSH if dysfunction is limited to Leydig cells etiologies [step1.medbullets.com]

In conclusion, assessment of serum AMH is helpful to evaluate gonadal function, without the need for stimulation tests, and guides etiological diagnosis of pediatric male hypogonadism. [ncbi.nlm.nih.gov]

There is no clear epidemiological data to indicate whether male hypogonadism is independently associated with clinical and biological sequelae of cancer cachexia, such as higher inflammation, fatigue, and body wasting. [ncbi.nlm.nih.gov]

Links: epidemiology aetiology hypothalamic - pituitary - gonadal (HPG) axis in testosterone deficiency (TD) clinical features screening and assessment for testosterone defiency (TD) investigation in testosterone deficiency treatment testosterone androgen [gpnotebook.co.uk]

4.0 is a contraindication to testosterone replacement (Bhasin, Endocrine Society, 2018) CBC – evaluate for increased red cell mass Hematocrit >55% is a contraindication to testosterone replacement Check at 3, 6, and 12 months, then annually Background Epidemiology [arupconsult.com]

This review discusses how to approach the finding of a low testosterone value, stressing the need to confirm the finding, the underlying pathophysiologic processes, drugs that can be responsible, and the importance of determining whether the cause is [ncbi.nlm.nih.gov]

Comprehensive and highly practical, Male Hypogonadism: Basic, Clinical, and Therapeutic Principles lucidly interprets a large body of scientific information on male reproductive endocrinology to provide a thorough understanding of the pathophysiology, [amazon.com]

The W28X mutation produces a truncated LHB peptide of seven amino acids, which prevents the synthesis of intact LH. After 40 days of treatment with hCG, the patient exhibited a few spermatozoa in the semen. [ncbi.nlm.nih.gov]

Prevention of Hypogonadism In many cases, such as with tumors, there is no way to prevent Hypogonadism. It can only be treated as symptoms arise. [hgh.tv]

Surgical repair helps prevent future complications. For secondary hypogonadism, doctors treat any underlying disorder of the pituitary gland or hypothalamus. [merckmanuals.com]