Male hypogonadismis defined as the underproduction of sperm or testosterone, or both, by the testes (also called testicles). Starting at puberty, the pituitary gland releases luteinizing hormone (LH), which stimulates the testicles to produce testosterone, the hormone responsible for male physical characteristics. In the testicles, follicle stimulating hormone (FSH) and LH also act together to stimulate the production of sperm.

Diagnosis of male hypogonadism begins with a medical history and physical examination. Many possible symptoms and signs may suggest low testosterone, orandrogen deficiency, in adult men:

Blood tests determine whether testosterone levels are in the normal range. This is generally 300 to 1,000 ng/dL (10.4 to 34.7 nmol/L), but the normal range may differ depending on the laboratory that conducts the test. To diagnose low testosterone, a man generally needs to have more than one early-morning blood test. If his blood testosterone is repeatedly low, then tests of pituitary gland function, such measuring LH and FSH levels, must also be done.

Male hypogonadism can beprimary(resulting from a problem with the testes) orsecondary(resulting from a problem with the pituitary gland or hypothalamus and their release of LH and FSH), or a mix.

Speaking more generally, low testosterone can be caused by:

Many older men have low testosterone levels and, in many cases, the cause isnt known.

Treatment with testosterone replacement therapy is recommended for men with consistently low testosterone levels and symptoms or signs of androgen deficiency. Men with one of the following should not be treated with testosterone replacement therapy:

The overall goal of testosterone hormone therapy is to increase testosterone levels from below the normal range to the middle of the normal range. Goals may vary from patient to patient but should include improving or maintaining the signs of masculinity (such as deep voice, beard growth, pubic hair), and improving sex drive and function,, mood and energy, muscle strength, and the amount of bone.

There are several ways to replace testosterone:

The way testosterone is given will depend on the patients preference and tolerance, and cost. The various types of testosterone therapy may have certain side effects. . Injections may be uncomfortable and linked to ups and downs in symptoms; patches may cause skin redness and rashes; gels may transfer testosterone to others who come into contact with the patients skin where the medication is applied; and buccal tablets may cause gum irritation.

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