Today I wanted to talk a little bit about hypogonadism in men. This is a clinical condition in which low levels of serum testosterone are found in association with specific signs and symptoms including diminished libido, fatigue, erectile dysfunction, depression, irritability, decreased muscle and bone mass, and anemia.

Common causes of hypogonadism are natural aging, chronic illnesses such Type 2 diabetes or HIV, congenital disorders such as Kleinfelter's Syndrome, mumps and other viruses, as well as trauma to the hypothalamus, pituitary, or the testes.

The prevalence of hypogonadism is more than you might think. Hypogonadism increases with age. Age-associated Sex Hormone Binding Globulin (SHBG) levels reduce bioavailable testosterone. As mentioned above, the prevalence is also higher in Type 2 diabetics.

A doctor's challenge is looking for these subtle, but common symptoms. It is important for the doctor to recognize that hypogonadism can cause confusing overlap with other conditions associated with sexual dysfunction, most notably, depression.

If you think you have hypogonadism, ask your doc to check your free testosterone. Remember, you want to be fasting for this test in order to get the most accurate results. Obtaining a total testosterone level, FSH, LH, SHBG, or prolactin levels are really not necessary when we are talking about physiologic replacement.

Replacement androgens can overcome the problem of hypogonadism, but should never be used in men with known or suspected cancer of the breast or prostate. All women should avoid skin contact with application sites in men who use gel replacement.

This is just a brief overview of this condition. I invite you to talk to your doctor about this if you have any signs or symptoms mentioned above.