Male hypogonadism

What is male hypogonadism?

Male hypogonadism means the testicles do not produce enough of the male sex hormone testosterone. When levels are low, men might have decreased sex drive, less muscle mass, erectile dysfunction, and fatigue.

Hypogonadism has a negative effect on organ function and quality of life. Testosterone is responsible for male reproductive and sexual functions. It affects puberty, fertility, muscle mass, body composition, bone strength, fat metabolism, sex drive, mood and mental processes (Fig. 1).

Testosterone is an androgen. Production of androgens decreases slightly with age. Low levels are more common in men who are obese and have multiple health conditions.

Hypogonadism in childhood

Hypogonadism can develop at any age but affects young children, adolescent boys, and men differently. It has little impact on young children and may well go away over time. In contrast, low hormone levels at puberty can
affect a boy’s sexual development.

Adolescent boys with hypogonadism typically have undeveloped muscles and genitals, a high-pitched voice, and little or no body hair. Breasts may form, and arms and legs may become out of proportion to a small torso as they continue to grow.

In most cases, a delay in development is normal and will correct itself, although the wait may be emotionally and socially difficult.

Check for hypogonadism if a boy:

  • Shows symptoms of hypogonadism
  • Has male family members who had hypogonadism
  • Has hormone levels that decrease, indicating Klinefelter syndrome
  • Has had injuries, infections, or medical treatments
    that can affect hormone levels

Living with hypogonadism

For most adults with hypogonadism, the condition is lifelong and treatment is ongoing. The goal is to improve quality of life, sense of well-being, sexual function, and muscle and bone strength. Hormone replacement combined with weight loss, a healthy diet, stopping smoking, and increasing exercise can help.

This information was produced by the EAU Patient Information Working Group, March 2017.

  • Dr. M. Sochaj, Gorzow Wielkopolsi (PL)
  • Dr. Y. Tanidir, Istanbul (TR)