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Epidemiology and Diagnosis of Hypogonadism

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Clinical Urologic Endocrinology

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Abstract

Testosterone production is dependent on the intact function of the hypothalamic–pituitary–gonadal axis. Primary hypogonadism stems from testicular dysfunction and can arise from injury or chromosomal/genetic causes. Hypothalamic and/or pituitary failure cause secondary hypogonadism, most often as a result of chromosomal or genetic defects. Late-onset hypogonadism describes abnormally low testosterone in fully developed males. In the absence of a specific pathology, this is most likely caused by a combination of central and peripheral dysfunction. Late-onset hypogonadism is strongly associated with advanced age and components of the metabolic syndrome.

Signs and symptoms of hypogonadism depend on the age of onset. Testosterone deficiency in utero can cause congenital malformations of the reproductive tract, which in the most severe cases can result in a female phenotype. Hypogonadism in adolescence can result in failure to undergo a normal pubertal development, including disturbances in the development of male secondary sexual characteristics. Late-onset hypogonadism produces symptoms, including reduced libido, erectile dysfunction, and decreased energy levels and decreased vitality. The diagnosis of hypogonadism relies on a combination of patient history, physical examination, and laboratory values.

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Abbreviations

BMI:

Body mass index

FSH:

Follicle-stimulating hormone

GnRH:

Gonadotropin-releasing hormone

HIM:

Hypogonadism in Males

HPG:

Hypothalamic–pituitary–gonadal

LH:

Luteinizing hormone

MMAS:

Massachusetts Male Aging Study

SHBG:

Sex hormone-binding globulin

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Authors and Affiliations

  1. Department of Urology, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, DK-2730, Herlev, Denmark

    Mikkel Fode M.D. & Jens Sønksen M.D., Ph.D., DSc (Med)

  2. Department of Urology, University of Michigan, 1500 E. Medical Center Dr., 0330, Ann Arbor, MI, 48108, USA

    Susanne A. Quallich MSN & Dana A. Ohl M.D.

  3. Department of Urology, Amstelland Hospital, Amsterdam, The Netherlands

    Yacov Reisman M.D., Ph.D.

Authors
  1. Mikkel Fode M.D.
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  2. Susanne A. Quallich MSN
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  3. Yacov Reisman M.D., Ph.D.
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  4. Jens Sønksen M.D., Ph.D., DSc (Med)
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  5. Dana A. Ohl M.D.
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Correspondence to Dana A. Ohl M.D. .

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Editors and Affiliations

  1. , Department of Urology, Austin Fertility & Reproductive Medicine, JAMES CASEY SUITE B 4303, AUSTIN, 78745, Texas, USA

    Parviz K. Kavoussi

  2. University of Virginia School of Medicin, University Of Virginia Hospital, 1300 Jefferson Parks Avenue, Charlottesville, 22903, Virginia, USA

    Raymond A. Costabile

  3. Department of Urology, University Vita-Salute San Raffaele, Via Olgettina 60, Milan, 20132, Italy

    Andrea Salonia

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Fode, M., Quallich, S.A., Reisman, Y., Sønksen, J., Ohl, D.A. (2013). Epidemiology and Diagnosis of Hypogonadism. In: Kavoussi, P., Costabile, R., Salonia, A. (eds) Clinical Urologic Endocrinology. Springer, London. https://doi.org/10.1007/978-1-4471-4405-2_3

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