Hypogonadism in Males - Late-Onset Disease Summary

Overview

Late-onset hypogonadism (LOH) is defined as a clinical and biochemical syndrome caused by androgen deficiency characterized by older age, a set of typical symptoms, and deficiency in serum testosterone levels, as stated in the Introduction section.

The prevalence of hypogonadism increases with age. A detailed discussion about the prevalence of late-onset hypogonadism is in the Epidemiology section.

The Pathophysiology section states that the suppression of the hypothalamic-pituitary-gonadal axis or a decrease in hypothalamic-pituitary and/or Leydig cell function may occur in association with obesity, diabetes, chronic inflammatory conditions, and other comorbidities. The developmental process of hypogonadism in patients affected is in this section.

Several factors may increase the risk of hypogonadism, and these are enumerated in the Risk Factors section.

Hypogonadism in Males - Late-Onset_Disease Summary

History and Physical Examination

The Clinical Presentation section describes the symptoms of hypogonadism.

The History section enumerates the important information that should be gathered in evaluating patients, while the Physical Examination section explains the assessments needed in the diagnosis of patients suspected of hypogonadism.

The Screening section lists several questionnaires that may be used to evaluate patients with hypogonadism.

Diagnosis

Discussions on serum testosterone levels and other investigations are in the Laboratory Tests and Ancillaries section. 

The Imaging section explains the indications for requesting a pituitary magnetic resonance imaging (MRI) in the management of hypogonadism.

Other conditions that should be considered and ruled out in the diagnosis of late-onset hypogonadism are listed in the Differential Diagnosis section.

Management

General therapy principles and management of hypogonadism are in the Principles of Therapy section.

The Pharmacological Therapy section discusses in detail testosterone preparations as a treatment option for hypogonadism, as well as potential benefits of therapy, adverse effects, and contraindications to testosterone administration.

The Nonpharmacological section explains the importance of lifestyle modification such as weight loss and physical activity, in the management of hypogonadism.

The Monitoring section discusses follow-up of patients with hypogonadism after testosterone treatment.