Late onset hypogonadism is defined as clinical and biochemical syndrome characterized by older age, set of typical symptoms, and deficiency in serum testosterone levels.
The quality of life may be decreased and multiple organ systems may be adversely affected.
Prior to the start of testosterone substitution, there should be confirmation of low serum testosterone and a confirmation of need based on clinical findings.
Only if the potential benefit exceeds the risk, then replacement testosterone should be started.


  • A type of hypogonadism that has normal pubertal development thus w/ developed normal male secondary sex characteristics
  • Prevalence of hypogonadism increases w/ age
  • Quality of life may be decreased
  • Multiple organ systems may be adversely affected


  • Late-onset hypogonadism (LOH) is defined as a clinical & biochemical syndrome caused by androgen deficiency characterized by:
    • Older age
    • Set of typical symptoms
    • Deficiency in serum testosterone levels

Signs and Symptoms

  • Decreased sexual desire & erectile quality & frequency; especially nocturnal erections
  • Mood changes, including:
    • Decreases in intellectual activity, cognitive function, spatial orientation ability
    • Fatigue
    • Depression
    • Irritability 
  • Sleep disturbances
  • Decrease in lean body mass w/ decrease in muscle volume & strength
  • Increase in visceral fat
  • Decrease in body hair & skin alterations
  • Osteopenia, osteoporosis & increased risk of bone fractures may develop from a decrease in bone mineral density
  • Hot flushes
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