Hypogonadism (Low Testosterone)

Understand. Diagnose. Treat. Thrive.

What Is Hypogonadism?

Hypogonadism in men is a condition where the body either:

  • Produces insufficient testosterone (the key male hormone), or

  • Has an impaired ability to produce healthy sperm (due to issues in the testes or the brain signaling the testes).

It can occur at any age, and if untreated, can significantly affect your health, fertility, and quality of life.

Signs & Symptoms of Low Testosterone

Men with hypogonadism may experience:

  • Chronic fatigue or low stamina

  • Loss of muscle mass despite regular exercise

  • Weight gain, especially belly fat

  • Low libido and poor sexual performance

  • Erectile dysfunction or loss of morning erections

  • Depressed mood, irritability, or anxiety

  • Cognitive difficulties – poor memory or focus

  • Gynecomastia (breast swelling) in younger men

  • Infertility due to impaired sperm production

What Causes Hypogonadism?

Hypogonadism can be categorized as:

Primary Hypogonadism (Testicular origin)

  • Genetic causes (e.g., Klinefelter syndrome)

  • Mumps orchitis, testicular injury or trauma

  • Chemotherapy or radiation

  • Testicular surgery

Secondary Hypogonadism (Brain origin – pituitary or hypothalamus)

  • Obesity

  • Pituitary tumors

  • Chronic illnesses or iron overload (e.g., hemochromatosis)

  • Use of steroids or opioids

  • Severe stress or sleep disruption

How We Diagnose Hypogonadism

At Male Sexual Health Clinic, we follow a systematic approach:

  • Morning testosterone blood tests (done twice to confirm low T)

  • Hormone profiling: LH, FSH, prolactin, thyroid panel

  • Physical examination: testicle size, body hair, muscle mass

  • Scrotal ultrasound or MRI brain (if pituitary cause suspected)

  • Semen analysis (if fertility is a concern)

Treatment Options

Treatment is based on your age, goals, fertility plans, and cause of hypogonadism:

For Men Not Planning Fertility

  • Testosterone Replacement Therapy (TRT) via:

    • Intramuscular injections (every 2–4 weeks or long-acting types)

    • Testosterone gels or skin patches

    • Testosterone pellets implanted under the skin

For Men Who Want to Preserve Fertility

  • hCG injections – stimulate natural testosterone production

  • Clomiphene citrate (SERM) – oral therapy to boost brain signals

  • Sometimes used alone or in combination with TRT to protect sperm output

When the Cause Is Reversible

  • Lifestyle change: weight loss, quitting offending drugs

  • Surgery: removal of pituitary tumor

  • Treatment of coexisting medical conditions

Ongoing Monitoring & Support

Men on therapy are monitored every few months to ensure:

  • Stable testosterone levels

  • Symptom relief and improved vitality

  • No serious side effects (e.g., blood thickening, acne, prostate issues)

We also assess:

  • Bone health (DEXA scans if needed)

  • Fertility status, if applicable

  • Adjustments to dosage, based on follow-ups

Living With Hypogonadism

Hypogonadism is common and treatable. We often see cases in Lucknow where:

  • Long-term stress

  • Sedentary lifestyle

  • Poor sleep habits

…lead to low testosterone levels.

With our evidence-based treatment and compassionate care, you can regain vitality, confidence, and reproductive health.

FAQs – Hypogonadism

How is this different from “male menopause”?

  • Male menopause (andropause) is age-related testosterone decline.

  • Hypogonadism can occur at any age, due to various medical causes.

  • A 25-year-old with pituitary dysfunction may have hypogonadism, not andropause.

  • Treatment approach is similar when low testosterone symptoms are present.

Can low testosterone affect fertility?

  • Yes. Intratesticular testosterone is vital for sperm production.

  • Low T can lead to low sperm count and infertility.

  • We adjust treatment with hCG or Clomiphene to boost both T and sperm.

Will testosterone shrink my testicles?

  • Yes, it can cause temporary shrinkage, as external T reduces brain signals to testes.

  • This is usually reversible.

  • To minimise this, we may add hCG therapy alongside TRT.

  • We discuss fertility and side effects before initiating therapy.

Can natural changes raise testosterone?

Yes – several lifestyle interventions can help:

  • Weight loss, especially if overweight

  • High-intensity workouts & resistance training

  • Sleep hygiene (7–8 hours/night)

  • Stress management

  • Avoiding alcohol and junk food

For many with borderline low T, these steps alone can normalise hormone levels.

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