5
Table 2. Symptoms and Signs Suggestive of T Deficiency
in Men
Specific symptoms and signs
• Incomplete or delayed sexual
development
• Loss of body (axillary and pubic) hair
• Very small testes (<6 mL)
Suggestive symptoms and signs
• Reduced sexual desire (libido) and
activity
• Decreased spontaneous erections,
erectile dysfunction
• Breast discomfort, g ynecomastia
• Eunuchoidal body proportions
• Inability to father children, low sperm
count
• Height loss, low-trauma fracture, low
bone mineral density (BMD)
• Hot flushes, sweats
Nonspecific symptoms and signs associated with T deficiency
• Decreased energ y, motivation, initiative,
and self-confidence
• Feeling sad or blue, depressed mood,
persistent low-grade depressive disorder
• Poor concentration and memory
• Sleep disturbance, increased sleepiness
• Mild unexplained anemia
(normochromic, normocytic)
• Reduced muscle bulk and strength
• Increased body fat, body mass index
Adapted with permission from Bhasin et al. J Clin Endocrinol Metab. 2010;95(6):
2536–2559.
Table 3. Conditions in Which Measurement of FT
Concentration is Recommended
Conditions that are associated with decreased SHBG concentrations:
• Obesity
• Diabetes mellitus
• Use of glucocorticoids, some progestins,
and androgenic steroids
• Nephrotic syndrome
• Hypothyroidism
• Acromegaly
• Polymorphisms in the sex hormone-
binding globulin (SHBG) gene
Conditions associated with increased SHBG concentrations:
• Aging
• HIV disease
• Cirrhosis and hepatitis
• Hyperthyroidism
• Use of some anticonvulsants
• Use of estrogens
• Polymorphisms in the SHBG gene
Total testosterone concentrations in the borderline zone around the lower limit of
the normal range (e.g., 200–400 ng/dL)
Adapted with permission from Bhasin et al. Androlog y 2018;6(1):151–157.
