Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management
Testosterone (T), the principal androgen secreted by the testes, plays an essential role in male health. Male hypogonadism is diagnosed based on a combination of associated clinical signs and symptoms and laboratory confirmation of low circulating T levels. In this review, we have highlighted factor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/24/3650 |
| _version_ | 1797381382259867648 |
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| author | Mark Livingston Adrian H. Heald |
| author_facet | Mark Livingston Adrian H. Heald |
| author_sort | Mark Livingston |
| collection | DOAJ |
| description | Testosterone (T), the principal androgen secreted by the testes, plays an essential role in male health. Male hypogonadism is diagnosed based on a combination of associated clinical signs and symptoms and laboratory confirmation of low circulating T levels. In this review, we have highlighted factors, both biological and analytical, that introduce variation into the measurement of serum T concentrations in men; these need to be considered when requesting T levels and interpreting results. There is an ongoing need for analytical standardisation of T assays and harmonisation of pre- and post-analytical laboratory practices, particularly in relation to the laboratory reference intervals provided to clinicians. Further, there is a need to share with service users the most up-to-date and evidence-based action thresholds for serum T as recommended in the literature. Estimation of free testosterone may be helpful. Causes of secondary hypogonadism should be considered. A comprehensive approach is required in the management of male hypogonadism, including lifestyle modification as well as medication where appropriate. The goal of treatment is the resolution of symptoms as well as the optimisation of metabolic, cardiovascular, and bone health. The advice of an endocrinologist should be sought when there is doubt about the cause and appropriate management of the hypogonadism. |
| first_indexed | 2024-03-08T20:51:40Z |
| format | Article |
| id | doaj.art-56068b61f65145a68722d4bb28f3a65c |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T20:51:40Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-56068b61f65145a68722d4bb28f3a65c2023-12-22T14:03:12ZengMDPI AGDiagnostics2075-44182023-12-011324365010.3390/diagnostics13243650Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and ManagementMark Livingston0Adrian H. Heald1Department of Clinical Biochemistry, Black Country Pathology Services, The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UKThe School of Medicine and Manchester Academic Health Sciences Centre, Manchester University, Manchester M13 9PL, UKTestosterone (T), the principal androgen secreted by the testes, plays an essential role in male health. Male hypogonadism is diagnosed based on a combination of associated clinical signs and symptoms and laboratory confirmation of low circulating T levels. In this review, we have highlighted factors, both biological and analytical, that introduce variation into the measurement of serum T concentrations in men; these need to be considered when requesting T levels and interpreting results. There is an ongoing need for analytical standardisation of T assays and harmonisation of pre- and post-analytical laboratory practices, particularly in relation to the laboratory reference intervals provided to clinicians. Further, there is a need to share with service users the most up-to-date and evidence-based action thresholds for serum T as recommended in the literature. Estimation of free testosterone may be helpful. Causes of secondary hypogonadism should be considered. A comprehensive approach is required in the management of male hypogonadism, including lifestyle modification as well as medication where appropriate. The goal of treatment is the resolution of symptoms as well as the optimisation of metabolic, cardiovascular, and bone health. The advice of an endocrinologist should be sought when there is doubt about the cause and appropriate management of the hypogonadism.https://www.mdpi.com/2075-4418/13/24/3650male hypogonadismandrogen deficiencytestosteroneassayerectile dysfunction |
| spellingShingle | Mark Livingston Adrian H. Heald Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management Diagnostics male hypogonadism androgen deficiency testosterone assay erectile dysfunction |
| title | Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management |
| title_full | Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management |
| title_fullStr | Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management |
| title_full_unstemmed | Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management |
| title_short | Adult Male Hypogonadism: A Laboratory Medicine Perspective on Its Diagnosis and Management |
| title_sort | adult male hypogonadism a laboratory medicine perspective on its diagnosis and management |
| topic | male hypogonadism androgen deficiency testosterone assay erectile dysfunction |
| url | https://www.mdpi.com/2075-4418/13/24/3650 |
| work_keys_str_mv | AT marklivingston adultmalehypogonadismalaboratorymedicineperspectiveonitsdiagnosisandmanagement AT adrianhheald adultmalehypogonadismalaboratorymedicineperspectiveonitsdiagnosisandmanagement |