Hypotestosteronemia in Male, Symptoms, Causes, Treatment

Hypotestosteronemia is the low level of testosterone in the body. It can be congenital or acquired deficiency. It is also medically known as Hypogonadism in which the functional activity of gonads decreases, leading to decreased production of hormones. Testosterone is a steroid hormone that is produced in the adrenal glands in both males and females. In males, testosterone is produced in the testes, while in females, it is produced in ovaries. The pituitary gland and hypothalamus regulate the release of testosterone. Males usually have high levels of testosterone than females. Testosterone roles in the body are given below:

· Puberty

· Increased muscle mass

· Bone mass formation

· Physical strength

· Sexual desire

· Facial hair

· Formation and maintenance of sex characteristics

Hypotestosteronemia in Male

Hypotestosteronemia in males is an acquired or congenital condition characterized by a low level of testosterone in males. It is associated with the low production of male sex hormone testosterone by adrenal glands. This condition is also known as male Hypogonadism. It can either be primary secondary or tertiary Hypogonadism. Testosterone plays an essential role in males by increasing muscle mass and bone density and is also associated with sexual and reproductive functions.

Females have a low level of testosterone than males. Under the American Urological Association guidelines, a normal male has at least 300 nanograms per deciliter of testosterone. Any male who has testosterone below 300 nanograms per deciliter is considered to have Hypotestosteronemia. The testosterone levels usually decrease with age. At around 19 years of age, males usually have a high level of testosterone, which starts to decrease at the age of 30. According to one of the studies, 40% of the males over the age of 45 years have an abnormally low level of testosterone.

For the diagnosis of hypotestosteronemia, a testosterone test is performed. The testosterone test measures the amount of testosterone in the blood. Since the number of testosterone changes throughout the day, this test is usually performed in the morning, since the testosterone level is highest in the morning. The factors such as age, disease, poor diet, body mass index, alcohol consumption, and medication can affect the level of testosterone.

Hypotestosteronemia in Male, Symptoms, Causes, Treatment

Hypotestosteronemia symptoms

A low level of testosterone has many symptoms that can affect the quality of life. The degree of symptoms depends upon the age and testosterone deficiency. Some of the symptoms of the low level of testosterone are given below:

· Erectile dysfunction or impotence

· Low sex drive

· Reduced body and facial hairs

· Reduced muscle mass

· Osteoporosis

· Decreased libido

· Reduction in strength  

· Infertility

· Gynecomastia

· Fatigue

· Reduce body mass index

· Mood swings and irritability

· Abdominal adiposity

· Mild anemia

· Reduction of testes size

· Hot flashes

· Reduction in memory

· Depression

· Inability to concentrate

· Sleep disturbances

Hypotestosteronemia causes

The causes of Hypogonadism can either be primary, secondary, or tertiary. Primary Hypogonadism is associated with the injury or failure of the gonads to produce enough testosterone, such as testicle injury or orchitis. Secondary Hypogonadism is associated with the regulation of testosterone by the pituitary gland like Kallmann syndrome. Tertiary Hypogonadism is due to the low secretion of gonadotrophins by the hypothalamus. The Hypotestosteronemia can either be acquired or heredity. Some of the causes of Hypotestosteronemia are given below:

· Injury to the testes

· Orchitis

· Alcohol consumption

· Chemotherapy or radiation

· Metabolic disorder

· Medication such as opiates

· Tumor pituitary gland or hypothalamus

· Delayed puberty

· Liver cirrhosis

· Kidney failure

· Sarcoidosis

· Myotonic dystrophy

· Head injury or trauma

· Kallman syndrome

· Klinefelters syndrome

· High level of Estrogen

· Weight loss or gain

· Uncontrolled Diabetes Mellitus

· Congenital defect

· Aging steroid use

Hypotestosteronemia treatment

The treatment of Hypotestosteronemia is commonly known as testosterone replacement therapy. In testosterone replacement therapy, testosterone medication is provided through oral, parenteral, topical, transdermal, or implantation.

· Oral tablets of testosterone are given in hypotestosteronemia. These oral tablets undergo first-pass metabolism due to which it is the least preferred route of administration. It is banned in the majority of countries.

· The most common testosterone replacement therapy route is the parenteral route in which intramuscular injection is given to treat the low level of testosterone. The injection is repeated after every 2 to 4 weeks

· The topical testosterone replacement therapy route includes the gel application, which contains testosterone daily on the upper arm, shoulder, back, or abdominal region. It does not undergo first-pass metabolism.

· The testosterone patches are applied on the upper arm, thigh, back, or abdominal region. In this transdermal route of administration, patches are applied every day.

· Another route of administration utilizes testosterone pellets, which are implanted in the skin and are effective for up to 6 months.




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