SHOULD FUNCTIONAL HYPOGONADISM BE TREATED?

[madman]

I say Dr. Zitmann for the win!

Take home message

 

[madman]

Dr. Zitzmann one of the true heavyweights in the field!

Worked under the grandmaster of testosterone the legendary Professor Eberhard Nieschlag!

Thread 'Effect of Androgen Receptor Polymorphism on Hypogonadism Severity'

Oct 19, 2024

*Average number of CAG repeats found was 23 ± 3.1, which is within the normal range as described by current literature

* Half of the patients (n=8) had [EF] subscores <14, indicating erectile dysfunction. However, Wilcoxon testing reveals that this difference is not significantly less than the cutoff (p=0.4375), a result likely due to the small sample size. These findings are consistent with the literature, which suggests that a correlation between CAG repeat length and erectile function only exists in eugonadal men.

* These data suggest that CAG repeat...

• madman
• Hypogonadsim Polymorphism Ar/cag Repeat Length
• Replies: 6
• Forum: Testosterone and Men's Health Articles

Dr. Michael Zitzmann, a prominent researcher in andrology and reproductive endocrinology, has made substantial contributions to elucidating the functional and clinical implications of the CAG trinucleotide repeat polymorphism in exon 1 of the androgen receptor (AR) gene on the X chromosome. This polymorphism encodes a variable polyglutamine tract in the AR protein's N-terminal domain, which inversely modulates the receptor's transcriptional activity: shorter repeats enhance AR transactivation, while longer repeats attenuate it, leading to subtle variations in androgen sensitivity even within normal testosterone ranges.




Dr. Michael Zitmann

 

[madman]

Dr. Adrian Dobs

 

[madman]

Hormone constellations in male hypogonadism

 

[madman]

Testosterone levels and ageing in men (n=10098)

 

[madman]

Testosterone (T) levels and symptoms

434 men (age 50-86 years)

 

[madman]

Prevalence of Hypogonadism in 1687 Men Presenting to an Outpatient Andrology Clinic

Obesity is something that is more likely to occur in advancing age

 

[madman]

Functional hypogonadism: only older men?

Functional hypogonadism and associated disease

EAA Guideline on functional hypogonadism_EVIDENCE:

* and we chat longitudinal data clearly document that obesity...and weight gain...increase the risk of developing functional...hypogonadism

So how does that actually work, again here is the axis...

 

[madman]

Effects of Weight Loss on Testosterone Levels

 

[madman]

EAA-Guideline 2020-Recommendation for Diagnosis

Very strong recommendation:

 

[madman]

THE T TRIALS

Largest set of clinical trials in functional hypogonadism: "T-Trials"

 

[madman]

AACE/ACE Guidelines

TTh required in functional hypogonadism: EAA guideline

 

[madman]

Take home message

 

[madman]

Yes going to end it here!

Watch the full webinar!

 

[madman]

Thread 'Updates in male hypogonadism: what is functional hypogonadism and how should it be managed?'

Sep 26, 2025

Dr Channa Jayasena

Functional hypogonadism - what is it?

SUMMARY: Men with functional. hypogonadism

Conclusion - before considering TRT

Conclusions if initiating TRT

• madman
• hypogonadism Mens Health/trt testosterone
• Replies: 19
• Forum: Testosterone and Men's Health Articles

 

[madman]

Effects of Weight Loss on Testosterone Levels
View attachment 53097

Thread 'The Effect of Weight Loss and Weight Loss Interventions on Sex Hormones'

Feb 14, 2026

Bariatric Surgery

Males

Bariatric surgery significantly influenced sex hormone levels in males. Estradiol (E2: Hedges’ g = − 0.90, 95% CI [− 1.30, − 0.50], P < .001), dehydroepiandrosterone (DHEA: Hedges’ g = − 0.50, [− 0.85, − 0.15], P = .005), and prolactin (PRL: Hedges’ g = − 0.30, [− 0.60, − 0.002], P = .049) exhibited significant decreases. Conversely, luteinizing hormone (LH: Hedges’ g = 0.40, [0.27, 0.35], P < .001), follicle-stimulating hormone (FSH: Hedges’ g = 0.55, [0.39, 0.72], P < .001), free testosterone (FT; Hedges’ g = 0.60, [0.24, 0.95], P = .001), total...

• madman
• diet Sex Hormones surgery weight loss
• Replies: 1
• Forum: Weight Loss Options

 

[madman]

Thread 'Functional Hypogonadism Uncovered: The Truth About Modern Testosterone Therapy and Men’s Health'

Feb 11, 2026

* Male hypogonadism is etiologically heterogeneous, broadly classified as: primary (hypergonadotropic) hypogonadism due to testes failure (e.g. from genetic conditions, trauma or gonadotoxic insults); secondary (hypogonadotropic) hypogonadism due to hypothalamic-pituitary disorders (e.g. tumors, trauma, exogenous opioids); or functional hypogonadism (FH), a reversible form often associated with systemic comorbidities. FH – sometimes termed age-related hypogonadism – occurs typically in older, multimorbid men and represents a combined dysfunction of both central and gonadal...

• madman
• aging hypogonadism Risks/benefits t therapy
• Replies: 7
• Forum: Testosterone and Men's Health Articles