Testosterone Therapy in Men With Hypogonadism

Last updated March 30, 2022

Key Points

Key Points

  • Hypogonadism is a clinical syndrome that results from failure of the testis to produce physiological concentrations of testosterone (T deficiency) and/or a normal number of spermatozoa due to pathology at one or more concentrations of the hypothalamic-pituitary-testicular axis.
  • Testosterone (T) deficiency can be due to testicular defects (primary hypogonadism), hypothalamus-pituitary defects (secondary hypogonadism) or both.
    • Primary hypogonadism results in low T concentrations, impairment of spermatogenesis, and elevated gonadotropin levels. The causes of primary hypogonadism are listed in Table 1.
    • Secondary hypogonadism results in low T concentrations, impairment of spermatogenesis, and low or inappropriately normal gonadotropin levels. Causes of secondary hypogonadism are listed in Table 1.
    • Combined primary and secondary hypogonadism results in low T concentrations, impairment of spermatogenesis, and variable gonadotropin levels.
  • Additionally, the process of evaluating secondary hypogonadism may uncover a deficiency/excess of other pituitary hormones or a hypothalamic or pituitary tumor that may require management in addition to treating hypogonadism

Diagnosis

...Diagno...

...Diagn...

...Diagnosis of Men wit...

...Society (ES) recommends diagnosing hyp...

...Screening and...

...nds against routine screening of men in the...

...Distin...

In men who have hypogonadism, ES recommends...

...Evalu...

...with hypogonadism, ES suggests furt...


...assification of Hypogonadism and Causes...


...s and Signs Suggestive of T Deficiency in...


...ble 3. Conditions in Which Measurement of...


...Approach for the Diagnostic Evaluation of Adult Me...


Treatment

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...Treatme...

...mmends testosterone therapy in hyp...

...ecommends against testosterone thera...

...who choose monitoring, clinicians should...

...al men being considered for testosterone...


...Older Me...

...nst routinely prescribing testosterone therapy to...

...men >65 years who have symptoms or condit...


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...ests that clinicians consider shor...


Men with Ty...

...men with type 2 diabetes mellitus who have...


...ons in Which T Administration Is Associated With...


...Clinical Pharmacology of T Formulations Approved i...


...Testosterone Formulations Available Outside the...


...tential Adverse Effects of T Replacement...


Monitoring

...Monitoring...

...Monitor...

...adal men who have started testosterone therap...

...ecommends a urological consultation for h...


...Monitoring Men Receiving T Therapy...