Hypogonadism (Testosterone deficiency)

Male hypogonadism is a clinical syndrome caused by testosterone deficiency which may adversely affect multiple organ functions and quality of life [1] .

Testosterone deficiency increases with age; an annual decline in circulating testosterone of 0.4-2.0% has been reported [2,3]. In middle-aged men, the incidence was found to be 6% [4]. It is more prevalent in older men, in men with obesity, those with co-morbidities, and in men with a poor health status.

Decreases in testosterone levels may increase the risk of osteoporosis, sexual dysfunction, fatigue, cardiovascular disease, and mood disturbances [5].

Hypogonadism associated with acute and chronic illness and can also occur as a result of the illness itself or its treatment. Some of the systemic illnesses associated with hypogonadism include burn injury, stroke, cancer, HIV disease, myocardial infarction, diabetes, obesity, surgical stress, and others [6].

1. Nieschlag E, Behre HM (eds). Andrology: male reproductive health and dysfunction. 3rd edn. Heidelberg: Springer, 2010.
2. Kaufman JM, Vermeulen A. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev 2005 Oct;26(6):833-76.
3. Wu FC, Tajar A, Pye SR, et al. Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging Study. J Clin Endocrinol Metab 2008 Jul;93(7):2737-45.
4. Hall SA, Esche GR, Araujo AB, et al. Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample. J Clin Endocrinol Metab 2008 Oct;93(10):3870-7.
5. AACE Guideline for Clinical Practice for the Evaluation and Treatment of Hypogonadism in Adult Male Patients- 2002 Update. ENDOCRINE PRACTICE Vol 8 No. 6 November/December 2002
6. Kalyani, R., Male Hypogonadism in Systemic Disease. Endocrinol Metab Clin N Am. 36 (2007) 333–348.