Hypogonadism (low testosterone)

Hypogonadism (low testosterone)

Male hypogonadism is a condition in which the testes do not produce enough testosterone, a hormone that plays an important role in sperm production and in male sexual development. Sometimes males are born with the condition, but it can also develop in adulthood as a result of other medical problems. Often hypogonadism can be treated with testosterone replacement therapy.

If hypogonadism occurs during fetal development, a male will have ambiguous or undeveloped male genitals. If it occurs during puberty or in adulthood, it may alter male physical characteristics and can impair normal erectile function and sperm production, decreasing a man’s fertility. The condition can cause other physical problems, such as a decrease in muscle and bone mass, and may sometimes affect cognitive and emotional functioning.

Certain genetic conditions put males at risk for hypogonadism, including Klinefelter syndrome and Kallmann syndrome. The condition can result from illnesses such as HIV/AIDS, tumors, and some cancer treatments. A drop in testosterone is also a normal part of the aging process, and in such cases, does not necessarily require treatment.

Hypogonadism is diagnosed on the basis of symptoms and on blood tests that measure testosterone.  If your testosterone level is low, your doctor will order additional tests to make sure you do not have an underlying condition such as a pituitary abnormality that requires treatment. 

Adult men with hypogonadism may be treated with testosterone replacement therapy to improve sexual function and restore muscle and bone strength. Testosterone can be delivered in several ways, including through injection, patch and gel. If a pituitary problem is the underlying cause of hypogonadism, surgery or replacement pituitary hormones may be indicated. Testosterone therapy may also be used in boys with underlying genetic conditions to encourage normal pubertal growth.

Testosterone therapy is NOT a treatment for infertility. In fact, treatment with testosterone is very likely to make fertility worse. However, several other treatments are possible for men who have both low testosterone and infertility.


Related Providers

• Associate Professor of Urology and Epidemiology & Biostatistics, • Chief of Urology, San Francisco General Hospital, • Director, UCSF Male Genitourinary Reconstruction and Trauma Surgery Fellowship, • Residency Program Associate Director
Associate Professor and Director, Male Reproductive Health