Case history
Case history #1
A 27-year-old man presents for evaluation of infertility. He had a normal birth and early development, but did not undergo puberty. He has developed none of the typical male secondary sexual characteristics. He reports diminished libido, although he occasionally gets early morning erections. He is able to get an erection during sexual activity, provided he is sufficiently aroused. He married 3 years ago, but attempts to father a child have been unsuccessful. His wife has normal menstrual cycles and her gynecological exam is normal. On examination, the patient has sparse facial hair and low hair line. Minimal bilateral, nontender gynecomastia is present. The patient has a normal penis and scrotum, but the testes are small and firm with an estimated volume of 4 mL each.
Case history #2
A 42-year-old man presents with a 4-month history of frontal headaches and decreased libido. The symptoms started gradually. In addition to decreased libido, the patient also complains of gradual loss of early morning erections. He has been married for 12 years and has 3 children. He denies any head or testicular injury. He also denies gynecomastia or galactorrhea. The only abnormality on his physical exam is bitemporal hemianopia on visual field testing.
Other presentations
In a neonate or child, hypogonadism may present with microphallus, cryptorchidism (especially if bilateral), or small testes.[7] Other presentations in adults include anosmia, osteoporosis, reduced strength and endurance, anemia, or vasomotor symptoms. Psychological clinical features include loss of motivation or concentration, irritability, low or labile mood, or poor body image.[7][8]
Use of this content is subject to our disclaimer