Male Hypogonadism

Male hypogonadism is a condition where the body doesn't make enough testosterone, enough sperm, or both. It can be present from birth or develop later in life due to problems involving the testicles or the brain signals (pituitary/hypothalamus) that control hormone production.

Symptoms can vary, but may include low sex drive, low energy, depressed mood, trouble concentrating, erectile dysfunction, infertility, loss of muscle mass, reduced facial/body hair, and bone loss (osteoporosis). Because many of these symptoms can have other causes, testing is important.

Guidelines generally recommend diagnosing hypogonadism only when someone has symptoms plus consistently low testosterone on lab testing. Testosterone is typically checked with a morning (often fasting) total testosterone, and the result is confirmed with a repeat morning test.

Depending on your symptoms and lab results, your provider may order additional hormone tests (such as LH/FSH and sometimes prolactin) to help determine whether the cause is testicular (primary) or related to pituitary signaling (secondary). If secondary causes are suspected, pituitary imaging may be considered. Fertility concerns may prompt semen analysis.

Treatment depends on the cause and your goals. Some men benefit from addressing contributing factors (medications, sleep, weight, or other health issues), while others may be candidates for testosterone replacement therapy (TRT). TRT comes in several forms (such as gels, patches, injections, or pellets) and requires follow-up monitoring to keep levels in a safe range.

It can. Testosterone therapy often lowers sperm production and may lead to very low sperm counts or no sperm on semen analysis while on treatment. If fertility is a goal, your endocrinology provider can discuss evaluation and alternatives that may better preserve fertility. If you're seeking low testosterone treatment in Atlanta, North Georgia Endocrinology can help you review symptoms, confirm diagnosis, and choose the safest plan.