The presence of hypogonadism may contribute to exercise intolerance. This can be important to recognize in an older adult starting an exercise program.

The risk of hypogonadism varies with age:

(1) young: congenital or hereditary cause

(2) adult: testicular trauma or surgery

(3) older adult: late-onset


Features in the young may include absence of male sexual maturation during adolescence.


Other features:

(1) erectile dysfunction, reduced libido or infertility

(2) depressed mood

(3) muscle weakness


The diagnosis of hypogonadism may be straightforward with a low total testosterone, or may be more subtle, requiring more complex testing to confirm (free testosterone, SHBG, LH, FSH, etc).

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