Signs And Symptoms

Signs and Symptoms

Many symptoms of hypogonadism in both men and women are non-specific and overlap with those of depression or chronic illness. Some common symptoms include:1

  • fatigue/decreased energy
  • feeling depressed or unmotivated
  • poor self-image

More specific symptoms of hypogonadism may not always be present, but can include:1

  • reduced libido and the inability to obtain an erection
  • changes in the pattern of hair growth
  • testicular atrophy
  • gynecomastia

Androgen deficiency has also been shown to contribute to:1

  • insulin resistance
  • anemia
  • osteoporosis (in men)
  • dyslipidemia (in men)
  • increased truncal fat (in men)

The Endocrine Society Clinical Guidelines2 provide further possible signs and symptoms that may lead to a diagnosis of androgen deficiency in male patients in the general population.

Table 1. Symptoms and signs suggestive of androgen deficiency in men2
A. More specific symptoms and signs
Incomplete or delayed sexual development, eunuchoidism
Reduced sexual desire (libido) and activity
Decreased spontaneous erections
Breast discomfort, gynecomastia
Loss of body (axillary and pubic) hair, reduced shaving
Very small (especially <5 ml) or shrinking testes
Inability to father children, low or zero sperm count
Height loss, low trauma fracture, low bone mineral density
Hot flushes, sweats
B. Other less specific symptoms and signs
Decreased energy, motivation, initiative, and self-confidence
Feeling sad or blue, depressed mood, dysthymia
Poor concentration and memory
Sleep disturbance, increased sleepiness
Mild anemia (normochromic, normocytic, in the female range)
Reduced muscle bulk and strength
Increased body fat, body mass index
Diminished physical or work performance

Adapted with permission from the Endocrine Society.2

Find out more about diagnostic tools for hypogonadism 

  1. Mylonakis E, Koutkia P, Grinspoon S. Diagnosis and treatment of androgen deficiency in human  immunodeficiency virus-infected men and women. Clin Infect Dis. 2001;33:857–864.
  2. Endocrine Society Clinical Guidelines on Testosterone Therapy in Adult Men with Androgen Deficiency  Syndromes. 2010. Accessed 22 February 2011.


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