What are symptoms of hypogonadism?
What are symptoms of hypogonadism?
The symptom most associated with hypogonadism is reduced libido, however other manifestations can also be associated with low testosterone, and a diagnosis of hypogonadism is made on the basis of low serum testosterone levels occurring in association with one or more of the symptoms and signs listed in the Table.1,2 However, please consult guidelines relevant to your country of practice as country-specific differences in the diagnosis and treatment of hypogonadism exist.
Figure: Common symptoms and physical signs of hypogonadism (low testosterone).
General signs and symptoms for hypogonadism
| Signs and symptoms suggestive of hypogonadism in men | Other, less specific symptoms and signs associated with hypogonadism |
|---|---|
| Incomplete sexual development, eunuchoidism, aspermia | Decreased energy, motivation, initiative, aggressiveness, self-confidence |
| Reduced sexual desire (libido) and activity | Feeling sad or blue, depressed mood, dysthymia |
| Decreased spontaneous erections | Diminished physical or work performance |
| Reduced muscle bulk and strength | Poor concentration and memory |
| Hot flushes, night sweats | Increased body fat, body mass index |
| Loss of body (axillary and pubic) hair, reduced shaving | Insulin resistance |
| Breast discomfort, gynecomastia | Sleep disturbance, increased sleepiness |
| Very small or shrinking testes | Mild anemia |
| Inability to father children, low or zero sperm counts | |
| Height loss, low trauma fracture, low bone mineral density (osteoporosis) |
Symptoms for hypogonadism based on onset of hypogonadism
| Organ/ affected function | Onset of hypogonadism before completion of puberty | Onset of hypogonadism after completion of puberty |
|---|---|---|
| Larynx | No voice mutation | No change |
| Hair | Horizontal pubic hair line; straight frontal hair line; diminished beard growth | Diminished secondary body hair; decreased beard growth |
| Skin | Absent sebum production; lack of acne; pallor; fine skin wrinkling | Decreased sebum production; pallor; fine skin wrinkling |
| Bone | Eunuchoid tall stature; osteoporosis | Osteoporosis |
| Haematopoiesis | Anaemia | Anaemia |
| Breast | Sometimes gynaecomastia | Sometimes gynaecomastia |
| Muscles | Underdeveloped | Atrophia |
| Penis | Infantile | No change/atrophy |
| Prostate | Underdeveloped | Atrophy |
| Testes | Small volume; often maldescensus | Decrease of volume |
| Spermatogenesis | Not initiated | Arrest |
| Mood | Reduced | Reduced |
| Erectile function and libido | Not developed | Loss |
Symptoms typically met in late-onset hypogonadism (LOH)
| Sexual | Other |
|---|---|
|
Diminished sexual desire and arousability (libido)
Loss of erectile quality and frequenc
Loss of particularly nocturnal erections
|
Depression, fatigue, lack of vigor, irritability
Decreased intellectual activity: cognitive functions, spatial orientation
Sleep disturbances
Decrease in lean body mass, diminution of muscle volume, and strength
Increase in visceral fat
Decrease in body hair and skin alterations
Osteopenia, osteoporosis, and increased risk of bone fractures
|
Related Topics
References
- Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2006; 91(6): 1995-2010.
- Wang, C., E. Nieschlag, R. Swerdloff, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA and ASA recommendations. Eur J Endocrinol 2008, 159(5): 507-514.