Alphabetical List / Testosterone Deficiency
Testosterone Deficiency
Overview. Testosterone deficiency, also known as hypogonadism, affects 5-8 million men in the United States . The deficiency can be present at birth or its onset can occur later in life, often as a result of a disease or injury.
The complications from not producing enough of the male sex hormone differ depending on the stage of life. When it occurs during fetal development, insufficient testosterone can result in incomplete development of sex organs. Lack of testosterone entering puberty can have a lasting impact on growth, including lack of body hair and impaired growth of the penis and testicles. When onset occurs after puberty, complications can include infertility, diminished libido, weakness, reduced muscle mass (including an increased risk of osteoporosis), enlarged male breasts, decreased facial and body hair growth, and depression or other mood disorders (in some cases, mood-related symptoms are similar to those of menopause in women). These problems may be more temporary and can improve with treatment, such as testosterone replacement therapy.
Anatomy. In addition to driving normal growth and development of male sex and reproductive organs, testosterone has a wide-ranging role in the development of secondary male sex characteristics including musculature, bone mass, hair patterns, and vocal tone. Normal testosterone levels help to maintain normal sex drive and fertility, as well as energy levels and healthy mood. Testosterone levels increase dramatically with the onset of puberty, and begin to decline after age 50.
Types and Causes. The source of testosterone deficiency may be primary (failure of the testicles to produce sufficient amounts) or secondary (failure stemming from the hypothalamus or pituitary gland – a problem of faulty signals from the brain to the testicles). Normal aging can cause primary testosterone deficiency – at least one in four men 75 and older has below-normal testosterone levels. Other causes of primary testosterone deficiency include Klinefelter’s syndrome (a congenital abnormality in which a male has one or more extra X chromosomes), undescended testicles, injury to the testicles, mumps infection involving the testicles, hemochromatosis (overproduction of iron), and the effects of chemotherapy or radiation treatment for cancer. Testosterone deficiency has also been found to be common in men with both type 1 and type 2 diabetes.
Obesity, HIV/AIDS, inflammatory disease, certain pain and hormonal medications, as well as pituitary disorders and impairment of the hypothalamus (the portion of the brain controlling secretion of pituitary hormones) such as occurs in Kallmann syndrome are among the secondary causes.
Diagnosis and Treatment. If symptoms suggest a deficiency, the level of testosterone in the blood can be measured to make a diagnosis, and further testing can be done to determine the cause. Testosterone replacement therapy is the most common treatment approach. Early detection and treatment in boys can help to prevent problems related to delayed puberty. Sometimes, injections of low doses of testosterone are used to induce puberty in boys.
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