Hypogonadism (Testosterone Deficiency Syndrome)


Hypogonadism is also known as Testosterone Deficiency Syndrome (TDS) or Andropause.

Hypogonadism is the medical term for having a very low testosterone (Low “T”) level.

What are the causes of  Testosterone Deficiency syndrome (Hypogonadism)?

It is caused when the testicles do not function normally or when internal hormone production is out of balance.

It affects men of any age.

  • Testosterone so important as it not only enables a man to have an erection and experience sexual desire (libido)
  • It is also important for
  • positive mood
  • physical energy
  • maintaining muscles
  • maintaining healthy bones

Because of this, the effects of low testosterone may cause symptoms of

  • Erectile dysfunction (impotence)
  • Loss of sexual interest (libido)
  • Lack of energy and concentration
  • Depression
  • loss of facial and body hair
  • Increased risk of developing fragile bones (osteoporosis)
  • Muscular weakness
  • Increased breast tissue (gynecomastia)
  • Small firm testicles

Read more about the other Causes of Erectile Dysfunction and Erectile Dysfunction Treatment.

A short video on Andropause (Male Menopause):

There are three main types of hypogonadism (Testosterone deficiency syndrome:

1.) Primary hypogonadism

Primary hypogonadism is the term used for low testosterone resulting from a problem within the testes.

This may be due to a genetic cause such as Klinefelter’s syndrome and Kallmann syndrome.


Due to physical damage to, or removal of, one or both of the testes.

2.) Secondary hypogonadism

Secondary hypogonadism is when the complex hormonal system responsible for producing male sex hormones goes out of balance or breaks down.

When the system works properly the testosterone level is kept within a normal range.

3.) Late-onset hypogonadism

Late-onset hypogonadism which is often left undiagnosed tends to develop later in life. 


If you think you have low testosterone levels, you can visit your doctor for full medical assessment, physical examination, and further blood tests.

This will determine whether your symptoms are due to primary or secondary hypogonadism.

The blood tests are usually done in the morning as this is when the testosterone in your blood is naturally at its highest.

If a genetic cause is suspected, this blood test will include a chromosome analysis as well as measuring your testosterone level.

You might need to undergo a few more tests, which may include looking for enlargement of the pituitary gland (which regulates the testosterone level in your blood). This is usually done by an MRI (magnetic resonance imaging) or a CT (computed tomography) scan.

Sometimes a bone density scan (a special scan of your hips and spine) may be recommended to check whether there is any sign of the weakening of the bones (osteoporosis), which can occur when low testosterone is left untreated.

Although these seem like a lot of tests to perform, these steps are very important in making an accurate diagnosis of hypogonadism and may influence the management and treatment you receive.

Treatment is aimed at restoring the normal level of testosterone to improve wellbeing, sexual function, quality of life and to prevent the development of osteoporosis.

There are now several preparations of testosterone available, all of which require your doctor to prescribe.

Whichever type of Testosterone Replacement Therapy (TRT) you take, you will need blood tests at regular intervals to check testosterone levels and ensure you do not develop side effects of treatment.

Different types of testosterone preparation available which includes: