Male hypogonadism

Lancet. 2014 Apr 5;383(9924):1250-63. doi: 10.1016/S0140-6736(13)61126-5. Epub 2013 Oct 10.

Abstract

Male hypogonadism is a clinical syndrome that results from failure to produce physiological concentrations of testosterone, normal amounts of sperm, or both. Hypogonadism may arise from testicular disease (primary hypogonadism) or dysfunction of the hypothalamic-pituitary unit (secondary hypogonadism). Clinical presentations vary dependent on the time of onset of androgen deficiency, whether the defect is in testosterone production or spermatogenesis, associated genetic factors, or history of androgen therapy. The clinical diagnosis of hypogonadism is made on the basis of signs and symptoms consistent with androgen deficiency and low morning testosterone concentrations in serum on multiple occasions. Several testosterone-replacement therapies are approved for treatment and should be selected according to the patient's preference, cost, availability, and formulation-specific properties. Contraindications to testosterone-replacement therapy include prostate and breast cancers, uncontrolled congestive heart failure, severe lower-urinary-tract symptoms, and erythrocytosis. Treatment should be monitored for benefits and adverse effects.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Affect / drug effects
  • Androgens / administration & dosage*
  • Bone Density / drug effects
  • Cardiovascular Diseases / chemically induced
  • Cognition Disorders / drug therapy
  • Contraindications
  • Diabetes Mellitus / etiology
  • Early Diagnosis
  • Gels
  • Humans
  • Hypogonadism* / diagnosis
  • Hypogonadism* / etiology
  • Hypogonadism* / therapy
  • Hypothalamo-Hypophyseal System / physiology
  • Insulin Resistance / physiology
  • Lipids / blood
  • Male
  • Muscle Strength / drug effects
  • Patient Satisfaction
  • Polycythemia / chemically induced
  • Prostatic Neoplasms / chemically induced
  • Quality of Life
  • Sexual Dysfunction, Physiological / drug therapy
  • Sleep Apnea Syndromes / chemically induced
  • Tablets
  • Testis / physiology
  • Testosterone / administration & dosage*
  • Testosterone / deficiency

Substances

  • Androgens
  • Gels
  • Lipids
  • Tablets
  • Testosterone