[…] testosterone production is normal because Leydig cells are not affected by ↑ temperature loss of negative feedback of testosterone results in ↑ LH FSH levels are variable based on presence of inhibin ↑ FSH if seminiferous tubule dysfunction is also present [medbullets.com]

الصفحة 69 - Men homozygous for an inactivating mutation of the follicle-stimulating hormone (FSH) receptor gene present variable suppression of spermatogenesis and fertility. Nat Genet 1997; 15:205-206. ‏ الصفحة 97 - Harman SM, Tsitouras PD. [books.google.com]

Symptoms and Signs Clinical presentation depends on whether, when, and how testosterone and sperm production are affected. (For presentation in adulthood, see Male Hypogonadism : Symptoms and Signs .) [merckmanuals.com]

• Male Hypogonadism

  Overview: Male Hypogonadism 14. Primary Male Hypogonadism 15. Primary Male Hypogonadism: Klinefelter's Syndrome 16. Primary Male Hypogonadism: Testicular Trauma and Anorchia 17. Primary Male Hypogonadism: Infectious Agents 18. [sciencemedia.com]

  Aim: The creation of new experimental model of primary male hypogonadism. Materials and methods: The study was conducted on the male Wistar rats, hypogonadism was modeled by temporary ligation of the distal part of the spermatic cord. [ingentaconnect.com]

  Primary male hypogonadism results from an intrinsic abnormalit...... DRG Epidemiology's coverage of male hypogonadism comprises epidemiological... [decisionresourcesgroup.com]

  NPs must select and follow the best guideline recommendations available to optimally treat male hypogonadism. [nursingcenter.com]

• Fatigue

  Symptoms include low testosterone, low energy, fatigue, and a lower sexual drive. [my.clevelandclinic.org]

  Typical symptoms include a low sex drive, erectile dysfunction, infertility, fatigue, weight gain and enlarged breasts. Over time, hypogonadism can lead to bone loss, which increases the risk of fractures. [nyhq.org]

  This is largely because the symptoms of hypogonadism are nearly identical to those experienced by men going through andropause (the male menopause): low libido, fatigue, depression, memory loss, difficulty concentrating, and irritability. [bodylogicmd.com]

  […] hypogonadism Prepubertal Delayed development of secondary sexual characteristics Small testes, genitalia Decrease in height Postpubertal Sexual difficulties Erectile dysfunction Infertility Decreased muscle and/or skeletal mass Decreased body hair Low energy, fatigue [arupconsult.com]

  These may include: Fatigue Decreased sex drive Difficulty concentrating Hot flashes When to see a doctor See a doctor if you have any symptoms of male hypogonadism. [mayoclinic.org]

• Anemia

  Other tests may measure thyroid hormones, sperm count and prolactin, a hormone released by the pituitary gland that stimulates breast development and milk production Tests also may be performed to test for anemia and possible genetic causes of symptoms [ucsfhealth.org]

  You may need to have tests to check: Estrogen level (women) Follicle stimulating hormone ( FSH level ) and luteinizing hormone ( LH) level Testosterone level (men) Other measures of pituitary function Other tests may include: Blood tests for anemia and [medlineplus.gov]

  By contrast, testosterone depletion is associated with: Loss of lean muscle mass Anemia Osteoporosis Insulin resistance Increased lipids (fat and/or cholesterol) in the blood Increased subcutaneous fat in the abdomen Testosterone Deficiency Testosterone [verywell.com]

  Nonspecific signs and symptoms include depressed mood, sleep disturbance, mild anemia, sleepiness after a meal, reduced muscle mass, and increased body fat. [ahcmedia.com]

  Less-specific but still commonly described symptoms may include depressed mood, difficulty sleeping, mild anemia, fatigue, or even increased body fat and BMI. 2,6,7 Objective examination must compare sexual development consistent with the patient’s age [uspharmacist.com]

• Unable to Bend

  These were poor morning erection, diminished sexual thoughts, erectile dysfunction, unable to do vigorous activity, limited in walking more than 1 km, and unable to bend (details in Supplemental Appendix published as supplemental data on The Endocrine [academic.oup.com]

• Decreased Muscle Mass

  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]

  Male hypogonadism symptoms during adulthood may include: Erectile dysfunction Infertility problems Decreased muscle mass Decreased body hair growth Loss of bone mass ( osteoporosis in men ) Gynecomastia Some men may develop symptoms similar to menopausal [health.in4mnation.com]

  […] of bone mass) Gynecomastia Decreased muscle mass Reduced body hair and beard growth Difficulty concentrating Low sex drive Fatigue It is not uncommon for men to gain weight or become irritable due to low levels of testosterone. [performanceinsiders.com]

  decreased muscle mass and strength loss of body hair (pubic, axillary, facial) osteoporosis and decreased bone mineral density increased body fat breast discomfort and enlargement hot flashes sweating poor concentration and decreased energy Causes Hypogonadism [medicalnewstoday.com]

  Low serum testosterone causes significant clinical impact and can result in erectile dysfunction, low libido, decreased muscle mass and strength, increased body fat, decreased bone density, decreased vitality and depressed mood. [lipocine.com]

• Sexual Dysfunction

  Depending on when it begins, hypogonadism may affect the development of sex organs, interfere with puberty or cause infertility and sexual dysfunction. Children with hypogonadism do not progress through puberty. [chop.edu]

  Dana Stoian, Ioana Mozos, Marius Craina, Corina Paul, Iulian Velea, Adalbert Schiller and Mihaela Craciunescu, Hypogonadism in Male Sexual Dysfunction, Sexual Dysfunction, 10.5772/intechopen.69107, (2017). [doi.org]

  It has less effect on erectile dysfunction (see later section on sexual dysfunction). [enotes.tripod.com]

  dysfunction is relatively low — about 2% in the European Male Aging Study. 35 However, while that study interpreted declining serum testosterone levels as causing sexual dysfunction, there is evidence that sexual activity modestly increases serum testosterone [mja.com.au]

• Testicular Disease

  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 [mja.com.au]

  Hypogonadism can be classified into primary hypogonadism as a result of primary testicular disease or secondary hypogonadism as a result of a central defect of the hypothalamus or pituitary gland (Table 1 ). [link.springer.com]

  Sperm are manufactured in cells known as seminiferous tubules, and these cells are more sensitive to the damage that results from most testicular diseases. [hgh.tv]

  Infiltrative diseases (hemochromatosis, amyloidosis) Chronic Systemic disease - Many chronic, systemic illnesses cause hypogonadism both by a direct testicular effect and by decreasing gonadotropin secretion. - Abnormalities of the hypothalamic-pituitary-testicular [enotes.tripod.com]

• Small Scrotum

  Such patients have poor muscle development, a high-pitched voice, inadequate phallic and testicular growth, a small scrotum, sparse pubic and axillary hair, and absent body hair. [merckmanuals.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]

Primary Hypogonadism | Secondary Hypogonadism | Rx of Hypogonadism | 2011 Screening and Workup for Testosterone Deficiency Martin M. [enotes.tripod.com]

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 [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 testosterone decreases, some men may experience signs and symptoms similar to those of menopause in women. These may include hot flashes, decreased drive, irritability, depression and fatigue. [healthguidance.org]

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

  A positive response is based on decreases in libido or strength of erections or any three nonspecific questions that include fatigability, decreases in muscle strength, mood changes, and loss of height. [care.diabetesjournals.org]

• Testosterone Increased

  […] in terms of bodyweight or metabolic syndrome. 43 The increase in testosterone level is proportional to the amount of weight lost: 10% weight loss increases testosterone by 2–3 nmol/L, whereas in morbidly obese men, profound weight loss after bariatric [mja.com.au]

  Sex hormone- binding globulin (SHBG), the major serum carrier of testosterone, increased by 1.2%/yr, with the net effect that total serum testosterone declined more slowly (0.4%/yr) than the free or albumin-bound pools alone. 32 33. [slideshare.net]

  Aromatase Conversion of Testosterone to Estrogen Some men are “ preferential aromatizer s”, meaning there is increased conversion of testosterone to estrogen via the aromatase pathway. [jeffreydachmd.com]

  This results in increased conversion of testosterone to estradiol and enhanced testicular secretion of estradiol relative to testosterone. [enotes.tripod.com]

• Hematocrit Decreased

  Check hematocrit; if it increases to >54%, stop therapy until hematocrit decreases into the normal range. Evaluate for OSA or other conditions associated with secondary erythrocytosis. Resume therapy at a lower dose. [clinicaladvisor.com]

  Risks of Testosterone/Androgen Therapy Fluid retention GynecomastiaAcne/oily skin Increases hematocrit Decreases HDL cholesterol (cardiovascular risk?) Sleep apnea Prostate diseases: BPH, prostate carcinoma Aggressive behavior (?) [enotes.tripod.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]

Updated evidence-based prescribing information reflects the latest national clinical practice guidelines and evidence-based treatment guidelines, including the latest clinical treatment guidelines for diabetes. NEW! [books.google.com]

METHODS: We performed a prospective, randomized, trial assigning 53 hypogonadal men to the following treatment groups: mesterolone 100 mg p.o. daily, testosterone undecanoate 160 mg p.o. daily, testosterone enanthate 250 mg i.m. every 21 days, or a single [ncbi.nlm.nih.gov]

Testosterone treatment may be acceptable in men with screen-detected organ-specific prostate cancer after definitive or clinically adequate prostate treatment. † Testosterone treatment only transiently worsens severity of obstructive sleep apnoea; this [mja.com.au]

Basal serum inhibin B levels were slightly higher before transdermal estradiol treatment (phase 1) than during estrogen treatment (phase 2) in both subjects. [jeffreydachmd.com]

Hypogonadism Treatment For men with primary hypogonadism, treatment typically involves lifelong testosterone replacement therapy. [froedtert.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]

[…] 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 [medbullets.com]

[…] body system manifestations due to the underlying etiology. [icd10data.com]

Prior to initiating therapy with AndroGel 1.62% Determine the specific etiology: If hypogonadism is suspected, identify the underlying medical condition that is causing it 1 Confirm the diagnosis: Investigate a diagnosis of hypogonadism by performing [androgelpro.com]

DRG Epidemiology's coverage of male hypogonadism comprises epidemiological... [decisionresourcesgroup.com]

This CME supplement discusses the definition, epidemiology and key signs and symptoms of late-onset hypogonadism, the role of lab measurements, factors to consider in selecting patients for testosterone replacement therapy, and how to identify the best [mdedge.com]

Epidemiology of Adult and Late-Onset Hypogonadism 25. Pathophyisology of Adult and Late-Onset Hypogonadism: Testosterone 26. Pathophyisology of Adult and Late-Onset Hypogonadism: Hypothalamus, Pituitary, Testes 27. [sciencemedia.com]

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]

Prader-Willi syndrome Neoplastic disorder Craniopharyngioma Germ cell tumors Histocytosis X Inflammatory cause Granulomatosis with polyangiitis Sarcoidosis Infection – Mycobacterium tuberculosis Age-related hypogonadism – pathology in testes and hypothalamus Pathophysiology [arupconsult.com]

Published on Apr 27, 2012 Male Hypogonadism :etiology, pathophysiology, prevalence, diagnosis by R.Tavakkolnia MD, urologist 1. HYPOGONADISM:ETIOLOGYEPIDEMIOLOGYPREVALENCE Rahim TavakkolniaDIAGNOSIS urologist 1 2. [slideshare.net]

This review will discuss the definitions, pathophysiology, causes, clinical manifestations, appropriate diagnostic testing procedures, and the role of testosterone supplementation with currently available formulations, with special attention to efficacy [ahcmedia.com]

Smith and Sardar Ali Khan, Obesity’s role in secondary male hypogonadism: a review of pathophysiology and management issues, SN Comprehensive Clinical Medicine, 10.1007/s42399-019-00056-7, (2019). [doi.org]

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]

What Should I Do to Prevent Testicular Cancer? To prevent testicular cancer, all men should be familiar with the size and feel of their testicles, so they can detect any changes. [webmd.com]

Testosterone replacement therapy can help restore muscle strength, and prevent bone loss. Replacement also increases energy, sexual function and sex drive, and a sense of well-being. [health.in4mnation.com]

The earlier it’s detected, the sooner he can prevent long-term effects and treat current symptoms. [thebump.com]

Coping and Support Prevent osteoporosis. If hypogonadism occurs during adulthood, make lifestyle and dietary changes to prevent osteoporosis. [diabetesalaska.com]