Definition of male androgen deficiency

This topic covers management of androgen deficiency in cis men; for advice on gender-affirming hormone therapy and gender-inclusive primary healthcare, see resources for trans and gender diverse health care. For information on androgen deficiency in childhood, see Delayed puberty in males.

Male androgen deficiency is defined as impaired testosterone production (due to proven dysfunction in the hypothalamic–pituitary–testicular [HPT] axis) that causes symptoms or effects on target organs.

Male hypogonadism is male androgen deficiency accompanied by impaired fertility; it may be:

• hypergonadotrophic—caused by primary (testicular) disorders that reduce testosterone production and spermatogenesis; these, in turn, reduce negative feedback on gonadotrophin (luteinising hormone [LH] and follicle stimulating hormone [FSH]) production, leading to increased gonadotrophin concentrations
• hypogonadotrophic—caused by a central (hypothalamic or pituitary) disorder that reduces production of gonadotrophins, diminishing stimuli to the testis to produce hormones and sperm.

For treatment of infertility in male hypogonadism, see Gonadotrophin therapy for male infertility.