Detecting Potential Hypogonadism
Perhaps the greatest difficulty is the early detection of potential Hypogonadism based on symptoms alone. Initial symptoms, such as lethargy and low moods, are easily confused with other ailments, sometimes resulting in the prescription of anti-depressants, which fail to help the patient.1

The AACE, 1 advocates a close examination of the patient's personal life and family history as helpful in determining potential with good reason. However, the patient can help enormously by performing a self-assessment prior to going to the doctor's surgery. The following symptoms are suggested in the AACE guidelines1

Symptoms In Babies and children
Low birth Weight for pregnancy term - Learning Problems - Undescended Testicles - Chronic Illness - Parental alcohol, or substance abuse, Hereditary conditions.1

Symptoms in Adults
Loss of Libido - Lethargy - Mood Swings - Anger - Anxiety - Depression - Aggression- Erectile Dysfunction - Obesity 1

The detection of Hypogonadism appears elevated in importance due to its association with aggression according to O'Connor DB, Archer J, Hair WM, et al80. Perhaps with this in mind, a new light can be shed on domestic violence and abuse.

Where Hypogonadism is indicated, detection and treatment is encouraged by the AACE, except where it is contra-indicated by other health issues.1


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Opinion
The AACE suggestions can only add to an over-burdened GPs workload. It seems illogical to interrogate every patient who thinks they may have a Testosterone problem, when a blood test would eliminate the necessity in all, but those who actually suffer from the condition. Sometimes it is wise to stand things on their head and look anew. If a an appropriate Testosterone test became routine in certain stages of development from birth, and was introduced into annual checks at relevant intervals during life, not only would detection rates improve, but doctors may obtain a head start on some late onset diseases. Such appears possible now, with the recent research into infant testing by Skakkebaek et al 29 and into pubertal testing by Mainieri A.S. Elnecave R.H 176
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