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Recognising late-onset hypogonadism: a difficult task for sexual health care
Journal of Men's Health, 09/16/09

Corona et al. – The authors found that although structured interviews, such as ANDROTEST or other self–reported questionnaires, might help physicians to familiarise themselves with hypogonadal symptoms and suspect LOH, LOH–related symptoms and signs are rather non–specific, as they are also characteristic of the ageing process per se. The authors confirmed that an accurate focused clinical history (inquiring about cryptorchidism, pituitary diseases and delayed puberty) can be very informative about the presence of LOH. In addition, sex life–related performances (libido, erection and ejaculation) and attitudes (masturbation and extra–marital affairs) might also provide insights. Clinical signs, such as testis volume, penile blood flow and the presence of the metabolic syndrome, can also raise the suspicion of LOH: an increased waist circumference increases the risk of having LOH by a factor of 3. Although a clinical evaluation is mandatory in suspecting LOH, it is the authors' opinion that the determination of total testosterone is essential in confirming the diagnosis and/or in starting any substitutive therapy.

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