Table 1.

Symptoms and Signs Suggestive of Testosterone Deficiency

Specific symptoms and signs  ● Incomplete or delayed sexual development  ● Loss of body (axillary and pubic) hair  ● Very small testes (<6 mL)

Suggestive symptoms and signs  ● Reduced sexual desire (libido) and activity  ● Decreased spontaneous erections, erectile dysfunction  ● Breast discomfort, gynecomastia  ● Eunuchoidal body proportions  ● Inability to father children, low sperm count  ● Height loss, low-trauma fracture, low bone mineral density  ● Hot flushes, sweats

Nonspecific symptoms and signs associated with testosterone deficiency  ● Decreased energy, motivation, initiative, and self-confidence  ● Feeling sad or blue, depressed mood, persistent low-grade depressive disorder. Poor concentration and memory  ● Sleep disturbance, increased sleepiness  ● Mild unexplained anemia (normochromic, normocytic)  ● Reduced muscle bulk and strength  ● Increased body fat, body mass index

Note: Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715–1744, doi:10.1210/jc.2018-00229. Reprinted by permission of Oxford University Press on behalf of the Endocrine Society.¹³