Male hypogonadism is characterized by insufficient testosterone production and may be classified as primary (testicular origin) or secondary (central origin). Clinical manifestations include reduced libido, erectile dysfunction, fatigue, decreased muscle mass, mood disturbances, and infertility.
Diagnosis requires confirmation of consistently low morning serum testosterone levels accompanied by relevant symptoms. Measurement of LH and FSH helps differentiate primary from secondary causes.
Guidelines from the Endocrine Society recommend careful patient selection prior to initiating testosterone replacement therapy (TRT). Monitoring includes hematocrit, lipid profile, liver function tests, and prostate-specific antigen (PSA).
Individualized therapy aims to restore physiological hormone levels while minimizing potential risks such as erythrocytosis erotic or cardiovascular complications.
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