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.
(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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