Inadequate sexual development, gynecomastia, infertility and sexual dysfunction are the symptoms and signs which most often result in an evaluation for male hypogonadism. The evaluation begins with a careful medical history and physical examination as described in detail elsewhere (Clark, 1994). A detailed sexual history should also be performed preferably with the partner present. Psychochological and marital factors which contribute to sexual dysfunction can be ascertained. Questions about libido are important because a decline in libido is a frequent symptom of hypogonadism, whereas most adult men with neuro/vascular erectile dysfunction have a preserved libido, at least initially. Testicular size should be measured carefully with a ruler or orchidometer. Hypogonadism beginning before the onset of puberty is discussed elsewhere in this volume (Chapter 5). The clinical characteristics of hypogonadism in adult men are listed in Table 1.
KeywordsTestosterone Level Leydig Cell Hypogonadotropic Hypogonadism Testosterone Deficiency Androgen Insensitivity Syndrome
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