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Male hypogonadism

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Abstract

The hypothalamic–pituitary–gonadal (HPG) axis regulates the development, endocrine and reproductive function of the gonads throughout all phases of life. Male hypogonadism is defined an inadequate gonadal function, as manifested by deficiency in gametogenesis and/or secretion of gonadal hormones. In most cases, male hypogonadism is diagnosed through detailed history, physical examination and a few basic hormonal evaluations. In selected cases, however, additional tests are needed to define the aetiology and the extent of HPG axis dysfunction. These include semen analysis, pituitary imaging studies, genetic studies, bone densitometry, testicular ultrasonography, testicular biopsy and hormonal dynamic testing. The stimulation tests of the HPG are of particular importance in the differential diagnosis of congenital delayed puberty versus pre-pubertal hypogonadism in children. This review will focus on the methods, indications and limitations of endocrine testing in the characterisation and differential diagnosis of male hypogonadism at various ages. A practical hands-on guide on how to perform these tests is also provided.

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Authors and Affiliations

  1. Department of Medical Pathophysiology (DFM-Fisiopatologia Medica), ‘Sapienza’ University of Rome, Viale del Policlinico 155, Rome, 00161, Italy

    Andrea M. Isidori, Elisa Giannetta & Andrea Lenzi

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  1. Andrea M. Isidori
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  2. Elisa Giannetta
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  3. Andrea Lenzi
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Correspondence to Andrea Lenzi.

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Isidori, A.M., Giannetta, E. & Lenzi, A. Male hypogonadism. Pituitary 11, 171–180 (2008). https://doi.org/10.1007/s11102-008-0111-9

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