Male Sexual health and Hypogonadism

What is testosterone?



Testosterone is commonly referred to as ‘Male hormone’. It is a hormone secreted mainly from testes. Small amount of testosterone is also synthesized in females from ovaries. Testosterone results in development and maintenance of secondary sex characters in males and necessary for normal sexual life in males (for example, penile enlargement, facial hair, interest in sex). The testosterone levels are regulated by hormones released the hypothalamus and pituitary glands in the brain.



What is male hypogonadism?



Hypogonadism is the failure of the body to produce sufficient testosterone to meet the body’s needs. Hypogonadism can be because of testicular failure or due to problem in the pituitary gland or hypothalamus.



What are the symptoms of Hypogonadism?




Low libido (decrease in desire for sex)

Erectile dysfunction (decrease in penis erection leading to sexual dissatisfaction)

Decrease in frequency of shaving

Decrease in body hairs

Gynecomastia (enlargement of breast tissue in males)

Lethargy, general malaise, depression, and mood swings

It can also result in increased risk for many diseases including Osteoporosis, Alzheimer’s, Diabetes, Arthritis and/or Cardio-vascular problems.




What is the cause of hypogonadism?



Some people are born with it, due to a genetic problem. Others acquire it because of reasons like environmental effects, alcohol intake, and smoking, drugs, (prescribed or otherwise), various systemic illness or injury.



What tests are done to diagnose hypogonadism?



Blood test for serum testosterone and other hormones like LH and FSH may be required to diagnose hypogonadism. You should consult Endocrinologist to get the required tests done and for precautions before the test.



What is the treatment of hypogonadism?



It depends on the cause of hypogonadism. At present, this condition is fully treatable. Commonly testosterone supplements are used in various forms depending on patient preference. One should consult Endocrinologist before starting treatment.



What is erectile dysfunction?



Erectile dysfunction (ED) is defined as the inability of a man to achieve and maintain an erection sufficient for mutually satisfactory intercourse with his partner.



How common is erectile dysfunction?



Approximately 50% of men over the age of 40 have some degree of erectile dysfunction – some mild, some severe. So, erectile dysfunction is very common. However, most men don’t seek help with a doctor. It’s estimated that only about 10-15% of men with Erection problems seek help, despite the fact that effective treatments are available. Embarrassment, fear, and discomfort talking about the subject and inability to find a right doctor, keep many men from the treatment they need to help themselves and their partners.



What causes erectile dysfunction?



Causes of erectile dysfunction can be physical and psychological. Reduced blood flow to the penis and leakage of blood out of the penis are the most common causes. A partial list of the many causes of ED includes the following:

Hormonal imbalances


Heart and vascular (blood vessel) disease

Neurological disorders

Chronic diseases (kidney or liver failure)

Drug and alcohol abuse

Side effects of some medications (antidepressant)

Psychological causes like work-related stress and anxiety, concern about sexual performance, marital or relationship problems, or depression




Are most cases of erectile dysfunction because of psychological causes?



No. Years ago, doctors felt that ED was caused by 90% psychological problem and 10% by physical problems. Now doctors know the opposite is true. About 90% of Erection problems are caused by physical problems with the blood vessels, veins, or nerves and only about 10% of cases are due primarily to psychological issues. Although, it is very common to have some degree of anxiousness, stress or even depression in patients with erection problems, but most often these come after a physical problem caused the erection problem, not before.



What is premature ejaculation?



Premature ejaculation is often confused with erectile dysfunction. Premature ejaculation is a condition in which the entire process of arousal, erection, ejaculation, and climax occur very rapidly, often in just a few minutes or even seconds, leaving the partner unsatisfied. Premature ejaculation may accompany an erection problem such as erectile dysfunction, but is generally treated differently.



What causes male infertility?



Infertility may result from a physical condition that is present at birth or that develops later in life. Examples of causes of male infertility include: Physiological dysfunctions, Hormonal imbalances, Testicular failure, Lifestyle factors etc.