Conditions in which screening for hypogonadism may be indicated in men
| Condition | Comments |
|---|---|
| Obesity | Can cause central hypogonadism and is a predictor for testosterone replacement therapy |
| Type 2 diabetes mellitus | An 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 syndrome | An association with low serum testosterone has been reported |
| Unexplained anemia | Moderate to severe testosterone deficiency is associated with lower hemoglobin |
| Low bone mineral density | The 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 disease | 22%–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) infection | Cohort 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 |
| Infertility | Pituitary and testicular causes of infertility may also cause hypogonadism |
| Hypothalamic and pituitary disorders | Can cause central hypogonadism |
| History of testicular radiation | Direct or scatter radiation may damage Leydig cells leading to primary hypogonadism |
| History of chemotherapy | Chemotherapy may be a risk factor for low testosterone |
| Opioid use | Chronic 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 use | A risk factor for low testosterone levels |
| History of androgenic anabolic steroid use | Chronic use can suppress hypothalamic-pituitary-testicular axis, causing hypogonadism upon withdrawal |