From Diagnosis to Treatment
Malehypogonadismis a deficiency in the sex hormonetestosteronein adult males and male children.
Low T in boys can cause delayed puberty.
In both instances, testosterone replacement therapy is the primary form of treatment.
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Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same.
A drop in normal testosterone, referred to as hypogonadism, can affect all these functions and more.
Puberty is generally considered delayed if physical and sexual changes are not seen by age 14.
Primary Hypogonadism
Primary hypogonadism is because of a defect of the testicles.
This may include a gloved examination of yourscrotum, testicles, penis, and breasts.
Lab Testing
The most important tool for the diagnosis of hypogonadism is theserum testosterone test.
This test measures the amount of testosterone in units of nanograms per deciliter of blood (ng/dL).
In adult males, the normal range is between 300 and 1,000 ng/dL.
According to guidelines issued by the American Urological Association (AUA).
These are hormones produced by the pituitary gland that stimulate the production of sperm cells and testosterone.
When taken together:
Based on the findings, other tests may be ordered.
In cases of testicular damage, TRT is the only form of treatment.
With congenital disorders or certain chronic diseases, lifelong TRT may be needed.
Boys with delayed puberty are typically treated with monthly intramuscular injections for anywhere from three to 12 months.
Depending on the underlying cause, male hypogonadism can sometimes be cured.
In other cases, low T may require lifelong management.
Risks and Complications
Despite the potential benefits, there are risks associated with TRT.
TRT is also avoided in men with untreatedprostate or breast canceras testosterone may stimulate the growth of a tumor.
Off-label means using a drug for a purpose other than for which it is approved by the FDA.
Many experts recommend making key lifestyle changes to correct problems that contribute to low testosterone as you get older.
Among the considerations:
Male vs.
Female Hypogonadism
Testosterone is important in people of all sexes.
Even so, testosterone is sometimes prescribed off-label to treat female hypogonadism, albeit with close medical supervision.
Possible risks of TRT in females includeendometrial bleedingand masculinizing effects (such asincreased facial and body hairandmale-pattern baldness).
There is also evidence that TRT may increase the risk ofhormone-sensitive breast cancersand heart disease.
The risk feels like dose-dependent, meaning that it increases in tandem with higher doses.
Summary
Male hypogonadism is abnormally low testosterone levels in males.
Hypogonadism in male children can lead to delayed puberty and stunted growth.
Hypogonadism is diagnosed based on symptoms and a testosterone blood test.
Testosterone replacement therapy is the primary form of treatment.
Infertile males with secondary hypogonadism may benefit from fertility drugs called gonadotropins.
August 12, 2022.
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Abdel-Sater KA.The role of anti-aging approaches in managing hypogonadism in sedentary older males.Front Aging.
A guide to prescribing testosterone for women in primary care.Br J Gen Pract.2020;70(693):203204. doi:10.3399/bjgp20X709265
