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Adult-Onset Hypogonadism
Mohit Khera1, Gregory A Broderick2, Culley C Carson3
1Baylor College of Medicine, Houston, TX.
Mayo Clinic Proceedings
|June 26, 2016
Summary
Experts defined adult-onset hypogonadism (AOH) in men with low testosterone and normal/low gonadotropins. This condition presents unique diagnostic and treatment challenges distinct from primary or secondary hypogonadism.
Area of Science:
- Andrology
- Endocrinology
- Sexual Medicine
Background:
- Men often present with low testosterone (T) and symptoms, but with normal or low gonadotropins.
- This presentation doesn't fit classical primary (testicular failure) or secondary (pituitary/hypothalamic failure) hypogonadism.
- The Sexual Medicine Society of North America (SMSNA) convened experts to address this clinical scenario.
Purpose of the Study:
- To define and characterize adult-onset hypogonadism (AOH).
- To differentiate AOH from primary and secondary hypogonadism.
- To provide a framework for AOH diagnosis, treatment, and monitoring.
Main Methods:
- An expert colloquium commissioned by the SMSNA in August 2015.
- A panel of 17 experts in men's health, sexual medicine, urology, and endocrinology.
- Deliberation on diagnostic processes, T therapy rationale, and patient monitoring protocols.
Main Results:
- Designation of the syndrome as adult-onset hypogonadism (AOH).
- Recognition of AOH's distinct characteristics, potentially involving elements of both primary and secondary hypogonadism.
- Development of recommendations for diagnosis, treatment rationale, and monitoring.
Conclusions:
- AOH is a common condition in middle-aged and older men.
- Understanding AOH is crucial for healthcare professionals.
- This document provides a conceptual framework to guide the evaluation and management of AOH.
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