Hypogonadism in Men

October 2022

Man and woman looking at each otherAn Estimated 4-5 Million Men in America Have Hypogonadism. But unfortunately, they never ask to have their levels checked because they think most of their symptoms are related to the “stress of life” or “getting older”.

What is Hypogonadism?

Hypogonadism is a condition in which the body doesn’t produce enough of the hormone Testosterone. Testosterone is important for sexual and reproductive development. It also is critical in Mental & Cognitive Health, Musculoskeletal Health & strength, Cardiovascular Health Optimization, along with a myriad of benefits that keeps a male’s body optimized.

Hypogonadism can occur at any age, but it’s symptoms are usually recognized by those above age 40. It can be caused by problems with the testicles, pituitary gland, or hypothalamus. These problems can be due to injury, infection, cancer, or other conditions.

What is the difference between Hypogonadism vs Aging “Low T”?

The main difference between Hypogonadism and aging “low T” is that Hypogonadism is a medical condition where the body doesn’t produce enough testosterone while aging “low T” refers to the natural decrease in testosterone levels that occurs as men age. Although both conditions have the same symptoms, it is important to report to a physician who knows how to diagnose you appropriately. Also, Health Insurance Companies will only cover your treatments for appropriately diagnosed Hypogonadism.

What are the symptoms of Hypogonadism in men?


  • Low Libido
  • Erectile dysfunction
  • Infertility
  • Sexual Anxiety


  • Fatigue
  • Foggy Head
  • Poor Memory
  • Scattered Thinking
  • Depressed Moods
  • Avoidance of activities and hobbies
  • Lack of enjoyment of life


  • Brittle and Thinning bones
  • Frail and weaker Connective tissue: Ligaments | Tendons | Cartilage
  • Weaker Muscle Mass and strength
  • Increasing Fat to Muscle ratio (leading to overfat and obesity)
  • Physiological:
  • Lower Metabolism
  • Higher sugars ( more prone to Diabetes)
  • More Risk for plaquing of arteries and therefore heart disease
  • Higher Inflammatory markers
  • Lower Immunity (most recently shown in Covid infection rate and progress)

What are the causes of Hypogonadism?

There are many potential causes of Hypogonadism, including:

  • Klinefelter syndrome – a chromosomal abnormality that affects males
  • Injury to the testicles or pituitary gland – from surgery, cancer treatment, or other conditions
  • Infection – such as mumps orchitis, a viral infection that can damage the testicles
  • Cancer – tumors of the testicles, pituitary gland, or hypothalamus
  • Other health conditions – such as diabetes, obesity, HIV/AIDS, and chronic liver or kidney disease
  • Certain medications – such as steroids, opioids, and certain antidepressants
  • Autoimmune disorders – such as Addison’s disease or hemochromatosis
  • Congenital defects – such as Kallmann syndrome or Prader-Willi syndrome

Still Yet, The Most common cause is “Idiopathic” or Unknown. Which is what has lead the prevalence rates to significantly increase from 1980s to Today.

How is Hypogonadism diagnosed?

The first step in diagnosing Hypogonadism is to review your symptoms and medical history with your doctor or a doctor specialized in Hormone Management. They may also recommend a physical exam and blood tests to measure your testosterone levels. If your levels are low, they may order additional tests to check for other causes. Dr. Kerendian at Delight Medical and Wellness Center has made such screening questions available for you to perform on their website.

Testosterone Screening

What are the treatments for Hypogonadism?

Treatment for Hypogonadism depends on the underlying cause. In some cases, no treatment is necessary. For example, if your levels are low due to a temporary condition, such as stress, your levels may improve on their own.
In other cases, treatment may be necessary. Treatment options are based on the individual’s lifestyle and preferences. This is why If you have Hypogonadism, it’s important to work with Specialized Doctors such as Dr. Payam Kerendian to find a treatment plan that’s right for you:

  • Hormone therapy – testosterone replacement therapy (TRT) is the most common and the safest form of hormone therapy. TRT can be given as an injection, patch, gel, or implant.
    • Testosterone Pellet Implants are the most favorite amongst patients as it allows for the smoothest and most natural delivery with the least side effect profile amongst all the other methods. It also lasts 3-5 months in your body which is less hassle for patients. As opposed to daily cream applications and Bi-monthly or weekly injections.
    • Dr. Payam Kerendian is one of a few physicians specialized in this treatment option within Southern California.
  • Anabolic steroids – these are synthetic hormones that can help increase muscle mass and strength. However, they can also have serious side effects, such as liver damage and aggression. –Dr. Kerendian avoids this treatment for 99.5% of his patients.
  • Surgery – Surgery may be necessary to remove a tumor or correct a birth defect. This is most common for those who get diagnosed with Severe Life halting Hypogonadism in the younger ages.