According to medical terminology (ICD 10), hypogonadism in males is a syndrome featured by dysfunction of reproductive organs and worsening of sex hormones production. “Hypogonadism” is a metabolic disorder, with the progression of which pain in the heart occurs, general health deteriorates, the structure of bone tissue changes, and obesity develops. The disease can occur in men in ages, in young men, as well as in infants.
In addition, low testosterone levels can be observed in women. However, this is a separate topic for study and we will not consider it.
Low Testosterone Symptoms — How Does the Condition Manifest Itself?
Low testosterone symptoms are to a great extent related to the age at which the disease has appeared. The signs of hypogonadism depend on the time of the disease occurrence. Therefore, specialists distinguish prepubertal (it is always primary) and postpubertal (can be primary or secondary) types. If the disorder appears before puberty, a patient suffers from the severe eunuchoid syndrome, severe gynecomastia, and paleness (pale complexion).
Symptoms of the illness also include non-pronounced secondary sex characteristics:
- There is a low amount of hair on the face and body. A child’s high voice does not transform into a rough one. Sexual organs do not develop properly (the penis is small in size; the scrotum is depigmented and has no labioscrotal folds). Moreover, the prostate gland is also underdeveloped, and it is often not possible to determine it by palpation.
- Secondary hypogonadism is characterized not only by the above-described consequences. Its frequent signs include obesity, hypothyroidism and thyroid adrenal cortex. Its symptoms include the absence of sexual desire and potency.
- Symptoms are less pronounced when the disease occurred after puberty. However, such symptoms as small balls, reduction of the hairline on the face and body, the loss of skin elasticity, are common. In addition, female-type obesity may be observed. Often signs of low testosterone include vegetative-vascular diseases and infertility.
Additional Signs of Low Testosterone — Depression, Anxiety, and Others
Men with testosterone insufficiency may suffer from depression, feeling devastated, anxiety, forgetfulness and absentmindedness, the inability to concentrate attention. In addition, sleep disturbance, which leads to nervous exhaustion and rapid fatigue, is possible.
Scientists note that the propensity to develop depression and increased anxiety in men with testosterone insufficiency remains underestimated by specialists, which prevents the timely treatment of these conditions. Scientists are confident in the advisability of conducting an additional study aimed at researching the relationship between low testosterone and mental health deterioration.
Main Causes of Low Testosterone
Causes of low testosterone may be different. Congenital primary hypogonadism can occur due to the following causes:
- deterioration of testicles development;
- cryptorchidism (the absence of one or both testes from the scrotum);
- the Shereshevsky-Turner syndrome or simply Turner syndrome (this disease is caused by chromosomal abnormalities, characterized by a lack of puberty and deterioration of physical development);
- Ahumada-Del Castillo syndrome (chromosomal underdevelopment of testicles leading to spermatozoa production suppression);
- incomplete masculinization (due to androgen insensitivity).
Acquired form of the disease can be a result of:
1) genital injuries, testicular tumors,
2) age factor (according to Harvard Medical School, T level declines by about 1% per year after the age of 40);
3) pesticides’ and alcohol’s toxic effects on the body;
4) taking large doses of hormones, for example, during the steroid cycle, so after the cycle, one needs to take anti-estrogens such as anastrozole. According to steroids before and after reviews by “juicers”, prolonged intake of these tablets can lead to a decrease in testosterone.
5) influence of radiation or chemotherapy, consequences of infectious diseases (vesiculitis, epidemic parotitis, deferentitis – inflammation of the vas deferens).
The secondary form can be caused by hypothalamic-pituitary-adrenal regulation abnormalities (due to tumors, inflammation, vascular conditions). The level of gonadotropins is needed for the synthesis of androgens, decreases.
How Do You Know if You Have Low Testosterone?
Low testosterone in men is a condition when the sex glands work poorly and sex hormones are not produced in healthy amounts. Diagnosis of hypogonadism is usually performed jointly by an endocrinology specialist, gynecologist, urologist (for men) and a reproductive endocrinologist (for women).
As mentioned earlier, the disorder can have primary and secondary etiology. Primary type can be detected immediately after the birth of a child. In case of this pathology, a baby doesn’t have testicles. To diagnose secondary hypogonadism, the patient needs to pass the following tests:
- quantitative human chorionic gonadotropin (hCG) blood test;
- general tests of blood and urine;
- study of chromosomal recruitment and chromatin;
- urine and blood T and hCG tests;
- detection of daily excretion of testosterone with urine;
- computed tomography (CT scan) of the head, examination of the fundus condition.
Low Testosterone Treatment: Basic Methods
Low testosterone treatment should be prescribed by a healthcare expert. Self-treatment measures are not advised. Prescription of medical remedies depends on the patient’s condition.
The treatment is aimed at normalizing androgen rates and improving sexual function.
Primary form, which is treated by stimulating therapy, is different for men and boys. For boys, the treatment usually includes non-hormonal drugs. Adults can take androgen and gonadotropin drugs in small quantities (that is, use hormonal therapy or HT). The same methodology is applied with acquired hypogonadism when the testicles retain reserves of Endocrinocytus cells. If the testicles lack these reserves, the intake of androgens (testosterone) is required throughout the life of the patient (the so-called lifelong therapy).
Secondary (hypogonadotropic) hypogonadism, whose treatment is quite different, involves the use of HT in any age. Treatment options for this condition include the combination of gonadotropins with sex hormones. Doctors also recommend doing gymnastics and performing general restorative treatment.
HCG can also be used to treat secondary form. Treatment is performed with the help of intramuscular shots of such drugs as Profasi, Gestoron, Medofasi, Materna-HCG, HCG Mochida, Predalon, Choragon, and Brevactid. Gonadotropins stimulate secondary sexual characteristics and increase the penis. Also, intramuscular injections of Omnadren and Nebido (steroid drugs) may be used. Sometimes steroids pills are used.
These drugs improve sexual function, reduce the amount of fat deposits while contributing to an increase in muscle mass.
Herbal pills (for example, the so-called over-the-counter steroids) are ineffective or not very effective in such cases.
Sometimes it is not possible to cure hypogonadism using conservative methods. In this case, patients need to perform a surgical procedure. A doctor can choose one of the following treatment options:
- testicular transplantation;
- descent of testis (for treatment of cryptorchidism);
- phalloplasty (if underdevelopment of the penis is observed);
- implantation of a synthetic testicle (if there is no undescended testicle in the peritoneum).
Surgical intervention is accepted to be carried out with the use of microsurgical techniques. The hormonal and immunological status of a person is carefully monitored.
Proper and regular treatment of the disease lead to normalization of male potency, helps to restore secondary sex features, and contributes to the disappearance of concomitant conditions like osteoporosis.
Consequences of Low Testosterone in Men
If left untreated, the disease may cause infertility. In male persons, hypogonadism can lead to excessive body weight and cardiovascular diseases. Hypogonadism-caused deposition of cholesterol in vessels can cause atherosclerotic changes. Osteoporosis can also be a concomitant condition: bones lose density, which increases the likelihood of bone fracture.