A testosterone deficiency (TD), also known as male hypogonadism, refers to the lack of testosterone, a male hormone responsible for sexual ability, male characteristics and normal brain function.
Testosterone is essential for the development of male sex and reproductive organs such as penis, testicles, scrotum, prostate and seminal vesicles.
Low level of this hormone causes a myriad of syndromes and problems in men?s lives.
The production of testosterone declines naturally with age.
The condition is often observed in middle-aged men.
Testosterone deficiency may also result from disease or damage to hypothalamus, pituitary gland or testicles.
Depending on age, insufficient testosterone production can lead to diminished libido, underdeveloped genitalia, erectile dysfunction, muscle weakness and osteoporosis, loss of body hair, and depression and other mood disorders.
Testosterone deficiency can be congenital or it may build up later.
Depending on the body organ where the problem first occurs, TD is classified into three different types, namely, primary testosterone deficiency (testicles), secondary testosterone deficiency (pituitary gland) and tertiary testosterone deficiency (hypothalamus).
While primary testosterone deficiency results in low testosterone and normal or high gonadotropin, secondary and tertiary types account for low testosterone and low gonadotropin levels.
The common congenital causes of TD are Klinefelter's syndrome (presence of an extra X chromosome), cryptorchidism and congenital hormonal disorders.
Acquired causes of TD include infections (e.
g.
, meningitis, mumps, or syphilis), radiation treatments, glandular malformation, testicular trauma, chemotherapy, isolated LH deficiency (e.
g.
, fertile eunuch syndrome), and tumors on the testicles, pituitary gland or hypothalamus.
Common diagnoses for testosterone deficiency include serum and blood testing, which is undertaken to determine the availability of testosterone and levels of leutenizing and gonadotropin-releasing hormones in the body.
Other tests include injecting GnRH or clomiphene citrate (an estrogen), and rarely, testicular biopsy that detects malfunctions in sperm production.
Testosterone deficiency treatments involve hormone replacement therapies including testosterone injections, gel, patches and capsules.
The selection of treatments is determined by age and extent of deficiency.
There are also some risks associated with testosterone replacement.
They include acne, mild fluid retention, breast enlargement, increased chance for sleep apnea and stimulation of prostate tissue.