Men's Health

Sex Hormone Deficiency

Low testosterone can result from dysfunction of endocrine tissue either in the testes in cases of primary hypogonadism or the hypothalamus or pituitary gland in cases of secondary hypogonadism. Either condition can produce the same syndrome of low testosterone:

• Decreased vigour and libido
• Decreased morning erections
• Depressed mood
• Decreased muscle mass and body hair (late finding)
• Hot flashes (late finding)
• Gynecomastia (breast enlargement)
• Infertility
• Small testes

Population-level screening for hypogonadism is not cost effective and is not recommended. However, patients with concerning symptoms or other clinical history that put them at a higher likelihood of having low testosterone should be tested, this includes patients with:

• Type 2 diabetes mellitus
• Osteoporosis or low-trauma fracture, especially in a young man
• Moderate to severe chronic obstructive lung disease
• Medications that affect testosterone productions, such has prolonged use of high-dose steroids and sustained-release opioids
• Diseases that may affect the hypothalamus or pituitary gland
• HIV-associated weight loss
• End-stage kidney disease and maintenance hemodialysis
• Infertility

Guidelines suggest that, due to variability of testosterone levels, a finding of low testosterone should be repeated two additional times before pursuing further investigations and/or hormone replacement. Hormone replacement is not without risks and should be discussed with a family physician, internal medicine physician, endocrinologist, or urologist.

If you have any concerning symptoms or even just questions, please call 623-1000 or book an appointment with Dr. Kwinter.