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Male Hypogonadism
April 2003

Q. I've read the American Association of Clinical Endocrinologists Medical Guidelines for the treatment of hypogonadism in adult male patients and have a query. There is considerable focus on infertility in the literature that deals with hypogonadism. Do I sense correctly from that document, that a history of fertility into middle age does not preclude the possibility of the long term presence of an endocrine disorder, such as that which might be caused by a pituitary adenoma or other endocrine disorder?

A. Male hypogonadism is a deficiency of testosterone, the male hormone, meaning the testes are failing to produce testosterone, sperm, or both. This can occur in infancy, during puberty, or in adulthood. The characteristics and symptoms will depend on the age of onset and the underlying cause.

Primary testicular failure means the testes never acquire the ability to produce hormones, whereas secondary means the testes fail due to lack of proper signal from the pituitary gland in the brain, or other causes. So a male could indeed have children and later be affected by a secondary cause of testicular failure.

This would be confirmed with a blood test finding low testosterone levels, and the treatment would depend on the underlying cause. An endocrinologist is the specialist who could help in this regard.



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