hypoandrogenic

Hypoandrogenic refers to a state characterized by lower-than-normal levels of androgens, the primary male sex hormones such as testosterone and dihydrotestosterone, and related androgens including DHEA and androstenedione. The term applies to both sexes and is most commonly discussed in the context of hypogonadism in men. Androgen levels vary with age, sex, laboratory method, and time of day, so diagnosis relies on biochemical testing combined with clinical assessment.

Common causes include primary hypogonadism, where the testes fail to produce testosterone (examples: Klinefelter syndrome, testicular injury, autoimmune conditions); secondary hypogonadism, due to hypothalamic or pituitary dysfunction (e.g., pituitary tumors, hyperprolactinemia), systemic illness, obesity, or medications such as glucocorticoids, opioids, or antiandrogens. In women and transgender men undergoing gender-affirming therapy, reduced androgen activity can also occur with medical regimens or ovarian/adrenal disorders. Symptoms in men may include reduced libido, erectile dysfunction, decreased facial and body hair, reduced muscle mass, fatigue, and loss of bone density; in women, signs can include menstrual irregularities, decreased libido, reduced body hair, osteoporosis, and fatigue. Many individuals have nonspecific symptoms that overlap with aging or other conditions.

Diagnosis is based on serum total and free testosterone (and sometimes DHEA, androstenedione, LH and FSH), measured in the morning, with consideration of age and assay reference ranges. Evaluation seeks underlying causes such as pituitary disease, testicular failure, or systemic illness. Treatment targets the underlying cause and may include testosterone replacement therapy in men with confirmed hypogonadism, with careful monitoring for adverse effects. In women, treatment is individualized and may involve addressing the underlying disorder or symptom-directed therapy; TRT is not routinely used in non-menopausal women. Lifestyle interventions and management of comorbidities can support outcomes.