Hypoandrogen-metabolic syndrome: a potentially common and underdiagnosed condition in men

Recently, it has been proposed that hypoandrogenaemia (hypogonadism, hypotestosteronaemia) may be a common accompanying factor in men with the metabolic syndrome (insulin resistance, Reaven's syndrome or syndrome X). When they are present together they may be considered as a specific entity, the hypoandrogen-metabolic (HAM) syndrome. The metabolic syndrome is common and its prevalence is predicted to increase in coming years. Hypoandrogenaemia, often unrecognised, is also common and may be an aetiological factor in the development of the metabolic syndrome in men. The prevalence of both hypoandrogenaemia and the metabolic syndrome increases with age and the clinician will frequently attend to men in their middle to advanced years with obesity, low androgen levels and metabolic syndrome. These conditions place men at an increased risk of cardiovascular and coronary heart disease and type 2 diabetes and can be simply investigated with weight, waist and blood pressure measurement and blood sample analyses. Men with HAM and symptoms of androgen deficiency may be managed by, in the absence of contraindications, testosterone replacement therapy along with weight reduction and other measures to normalise glucose, lipid and blood pressure control.