Androgens are a category of sex hormones responsible for the ‘male’ characteristics in men, with the major sex hormone being testosterone produced in the testes. They are essential in male reproductive and sexual function, as well as in developing their unique characteristics such as body and facial hair growth and voice change. Lastly, androgens also affect metabolism and muscle and bone development.
A deficiency in androgens (also referred to as male hormone deficiency) means your body is not making enough hormones, particularly testosterone, necessary for full health, with the effects depending on its severity, cause, and age at which it begins.
An Overview of Testosterone
Testosterone is the major sex hormone in men with many various functions in the male body, including
- Sperm production
- Body and facial hair growth
- Prostate gland function and growth
- Sexual function and libido
- Muscle and bone development
- Start and completion of puberty
Symptoms and Causes of Androgen Deficiency
A wide range of symptoms can occur when there is insufficient testosterone in the body, many of which may be non-specific and overlap with the symptoms of other health conditions. These include:
- Reduced libido
- A lower amount of ejaculate
- Weaker orgasms and erection
- Sweating and hot flushes
- Fatigue and lethargy
- Reduced strength and muscle mass
- Reduced bone mass and higher risk of osteoporosis
- Loss of body hair
- Increased body fat
- Gynaecomastia or breast development
- Depression
Some causes of this deficiency include conditions affecting the testes, hypothalamus, and pituitary gland.
Medical issues affecting the testes can prevent it from producing enough testosterone, which can be present from birth, as in the case of genetic disorders like Klinefelter’s syndrome. Other conditions may happen at any point in the male’s life, such as:
- Complications from mumps
- Undescended testes
- Loss of testes due to torsion (twisting off of the blood supply) or trauma
- Side effects of radiotherapy or chemotherapy
The most common condition affecting the pituitary gland is the presence of a benign tumour or adenoma, which leads to low testosterone levels. It could interfere with the pituitary gland’s functioning or produce the prolactin hormone that stops the production of gonadotrophins, hormones necessary for prompting the testes to create testosterone.
Lastly, there is the rare case of the hypothalamus being affected by certain conditions like tumours or genetic disorders that prevent it from signalling the pituitary glands from releasing hormones, which inhibits the production of testosterone by the testes.
Diagnosis and Treatment of Androgen Deficiency
Diagnosing androgen deficiency is done through several assessments such as:
- Medical history
The patient’s complete medical history is reviewed, particularly details concerning sexual function, fertility, symptoms of androgen deficiency, medication and drug abuse, occupation, and other medical problems. - Blood tests
Blood tests help reveal the testosterone levels in the blood. Fasting blood tests in the morning is ideal since it is during this time when the body is at its peak release of testosterone. - Physical examination
A thorough general exam helps to check for breast development and measure the size of the testicles. - Other tests
If other underlying medical conditions cause androgen deficiency, other tests like genetic tests, blood tests for iron levels, and brain MRI scans (to examine the pituitary gland) may be necessary.
Upon complete diagnosis, treatment will be based on testosterone replacement therapy, wherein testosterone is administered via skin creams, gels, or short or long-acting injections. Patients undergoing this therapy will have regular reviews with their physician, depending on their age and other risk factors surrounding prostate cancer. It is vital to note that testosterone treatment therapy could lead to potential side effects, including mild acne, weight gain, increased aggression and mood changes, and male pattern baldness.
Suppose the patient’s testosterone deficiency is caused by their pituitary gland, and they are planning on fathering a child. In that case, healthcare professionals will likely recommend gonadotrophin injections to stimulate testosterone and sperm production.
However, testosterone treatment is inadvisable for androgen deficient patients trying to have a baby since it works as a strong contraceptive that suppresses the pituitary hormones responsible for sperm production. In these cases, it is recommended to seek a fertility specialist for advice.
Conclusion
Androgen deficiency occurs when there are low levels of male sex hormones (specifically testosterone) circulating in the body that are needed for good health, which may be caused by problems in the brain controlling the functioning of the testes or a problem in the testes themselves. Although a gradual and modest drop in sex hormones is observed across male populations around the age of 30, this fall is not prevalent among all men. In most cases, this reduction is caused by the other illnesses they develop along the way.
If you need an expert diagnosis, medical help, and treatment for androgen deficiency, Elyon Clinic is always ready to lend a helping hand! As a highly reputable men’s health clinic in Singapore, you can rely on our healthcare professionals to help you understand and combat the natural decrease of male hormones through consultations, tests, and treatments to improve your health. Feel free to contact us at 6802 7208 for an appointment.