Male hypogonadism is a deficiency of the hormone testosterone. Testosterone is essential for bone and muscle development, sex drive and other male characteristics, and its decline can seriously affect health.
Why testosterone matters
Testosterone is known as the “male hormone”. It supports the development and strengthening of bones and muscles, sex drive and the formation of other male characteristics.
Testosterone is not only a sexual health hormone: it protects the cardiovascular system, strengthens bones and is involved in regulating metabolism.
Age-related decline and late-onset hypogonadism
After the age of 40, testosterone levels begin to decline physiologically. This is also called andropause. The decline is very gradual – roughly 1–2% per year. However, a sharp drop in this hormone can seriously harm men’s health.
Late-onset male hypogonadism is a combination of clinical and biochemical signs in men with normal development and normal secondary sexual characteristics, in whom testosterone declines with age, accompanied by age-related diseases and general health problems.
Do not dismiss the following complaints as “normal ageing”:
- persistent fatigue
- reduced sex drive
- loss of muscle mass
- lack of motivation
When to see an endocrinologist
Signs of testicular insufficiency may appear in you or your relatives in the following situations – in such cases, be sure to see an endocrinologist:
- delayed or incomplete descent of the testis into the scrotum
- congenital urinary tract anomalies
- delayed or incomplete puberty
- breast enlargement starting in puberty or later
- erectile problems, reduced libido
- genital infections, orchitis
- medications, alcohol use, exposure to pesticides, chemicals and radiation
- chemotherapy for cancer
- long-lasting diseases affecting the function of several organs
What testosterone deficiency affects
- Fertility: hypogonadism reduces sperm count and motility. If pregnancy does not occur for a long time, it is important to look for the cause at the endocrine level as well.
- Metabolism: low testosterone in men increases insulin resistance and raises the risk of diabetes.
- Gynecomastia: a shift in the balance between testosterone and estrogen effects may play a role in the growth of breast tissue in men; testosterone deficiency is one of its causes.
Diagnosis
Every man suspected of having hypogonadism should be examined. Total testosterone must be measured in the morning, between 07:00 and 10:00.
In fertility problems, tests such as LH, FSH, prolactin, TSH, FT3, FT4, insulin and HOMA-IR are performed alongside testosterone.
Treatment and lifestyle
With appropriate treatment, testosterone deficiency can be prevented and the age-related decline slowed. For this, the doctor prescribes hormone replacement therapy with testosterone preparations. Patients starting treatment are informed about possible side effects and are invited for regular follow-up visits.
In addition to medication, lifestyle changes that have a positive effect on testosterone levels include:
- regular exercise, including weight training
- a balanced diet
- maintaining an ideal body weight
- regular sleep
- quitting smoking and alcohol
- keeping stress under control
The information on this page is general and does not replace a medical examination.