3.17b_11 Testosterone Deficiency and Male Hypogonadism

Testosterone Deficiency and Male Hypogonadism
Session Overview
Description
Many men experience a gradual decline in bioavailable testosterone with age. It is associated with osteoporosis, diabetes, heart disease, depression and cognitive decline. This session provides an overview of investigation and management.

This session was reviewed by Khyati Bakhai and last updated in March 2020.

Learning Objectives
By the end of this session you will be able to:

• Define the andropause
• Describe the presentation of male hypogonadism, recognise the major types of male hypogonadism and list the causes
• List the problems associated with testing for testosterone deficiency
• Recognise the complications of primary hypogonadism in older men
• Describe the management of older men with hypogonadism

Testosterone levels in men decline naturally with age. This is commonly termed the andropause or male menopause.

This is a misleading term because it implies a sudden and complete cessation of male sex hormone production with resultant loss of fertility. In reality, the process is more of a gradual reduction, and not cessation, of testosterone production.

As a result, other terms have also been used to describe the same phenomenon. These include:

• Symptomatic late-onset hypogonadism (SLOH)
• Androgen deficiency (or decline) of the ageing male (ADAM), or
• Partial androgen deficiency in ageing males (PADAM)