Conditions in which screening for hypogonadism may be indicated in men

ObesityCan cause central hypogonadism and is a predictor for testosterone replacement therapy
Type 2 diabetes mellitusAn independent association with male hypogonadism has been reported
One-third of men with type 2 diabetes mellitus have low testosterone in cross-sectional studies
Metabolic syndromeAn association with low serum testosterone has been reported
Unexplained anemiaModerate to severe testosterone deficiency is associated with lower hemoglobin
Low bone mineral densityThe relationship between low testosterone and low bone mineral density is not definite, yet guidelines recommend measuring serum testosterone in men with osteoporosis or low-trauma fracture
Chronic obstructive pulmonary disease22%–69% of men with chronic obstructive pulmonary disease have been reported to have hypogonadism
Testosterone replacement may benefit patients in terms of exercise capacity
Human immunodeficiency virus (HIV) infectionCohort studies showed that 17%–38% of men who are HIV-positive have low testosterone
Testosterone replacement in men with HIV-associated weight loss can improve body weight, muscle mass, and mood
InfertilityPituitary and testicular causes of infertility may also cause hypogonadism
Hypothalamic and pituitary disordersCan cause central hypogonadism
History of testicular radiationDirect or scatter radiation may damage Leydig cells leading to primary hypogonadism
History of chemotherapyChemotherapy may be a risk factor for low testosterone
Opioid useChronic opioid use can lead to testosterone deficiency in up to 50% of men
Hypogonadism in a young man should alert physicians to possible opioid abuse
Chronic glucocorticoid useA risk factor for low testosterone levels
History of androgenic anabolic steroid useChronic use can suppress hypothalamic-pituitary-testicular axis, causing hypogonadism upon withdrawal