Table 3. Clinical signs and symptoms suggestive of TD.

Sexual	Physical
Erectile dysfunction Reduced sexual desire and activity Reduced or absent morning/night-time erections Delayed puberty Small testes Infertility Reduced frequency of sexual thoughts Delayed ejaculation Reduced volume of ejaculate	Reduced body hair Gynaecomastia Reduced muscle mass and strength Hot flushes/sweats Sleep disturbances Fatigue Osteoporosis/height loss/low trauma fractures
Cardiometabolic	Psychological
Increased BMI/obesity Visceral obesity Metabolic syndrome Insulin resistance, pre-diabetes and type 2 diabetes	Changes in mood (e.g., anger, irritability, sadness, depression) Reduced well-being/poor self-rated health Diminished cognitive function (including impaired concentration, verbal memory and spatial performance)

TD: testosterone deficiency, BMI: body mass index.

Data from Hackett et al (Int J Clin Pract 2017;71:e12901) [1], Dohle et al (http://uroweb.org/guideline/male-hypogonadism/) [4], and Khera et al (J Sex Med 2016;13:1787-804) [6].