genitourinary disorders
Male Hypogonadism
Symptoms and Signs of Male Hypogonadism
Age at onset oftestosteronedeficiency (congenital, childhood-onset, or adult-onset hypogonadism) dictates the clinical presentation. deficiency results in abnormalities ranging from ambiguous external genitals to Hypospadias . Second- or 3rd-trimester onset of (see Male Hypogonadism in Children ) has few consequences and usually is unrecognized until puberty is delayed. Untreated hypogonadism impairs development of secondary sexual characteristics. As adults, affected patients have poor muscle development, a high-pitched voice, a small scrotum, decreased phallic and testicular growth, sparse pubic and axillary hair, and an absence of body hair. They may develop gynecomastia and eunuchoidal body proportions (arm span has varied manifestations depending on the degree and duration of the deficiency. Decreased libido; Erectile Dysfunction ; decline in cognitive skills, such as visual-spatial interpretation; sleep disturbances; vasomotor instability (in acute, severe male hypogonadism); and mood changes, such as depression and anger, are common. Decreased lean body mass, increased visceral fat, testicular atrophy, osteopenia, gynecomastia, and sparse body hair typically take months to years to develop. 