Many men in the United States may have symptomatic testosterone deficiency (defined as T levels below 300 ng/dL with associated symptoms). T deficiency can be diagnosed with a simple blood test. U.S. sales of T-replacement therapies were $1.9 Billion in 2015. T-gels comprised 87% of these sales.
We believe a large number of men with T deficiency remain untreated or do not adhere to their T-replacement therapy because of dissatisfaction with currently available T-replacement therapies.
Common symptoms of T deficiency include:
- Reduced sexual desire and activity
- Decreased spontaneous erections
- Breast discomfort or breast development in men
- Loss of body hair
- Height loss, low trauma fracture, low bone mineral density
- Hot flushes or sweats
- Decreased energy, motivation, initiative, and self-confidence
- Feeling sad or depressed mood
- Poor concentration and memory
- Sleep disturbance, increased sleepiness
- Mild anemia
- Reduced muscle bulk and strength
- Increased body fat, body mass index
- Diminished physical or work performance
Hypogonadism may result from a genetic abnormality or may occur secondary to a chronic disease or from certain drug therapies. Clinical findings in adult men with the androgen deficiency component of hypogonadism are non-specific.
There are two types of hypogonadism: primary hypogonadism and secondary hypogonadism:
- Primary hypogonadism is caused by the failure of the testes to synthesize and secrete T. Causes of primary hypogonadism include Klinefelter's syndrome, a condition in which males have an extra X sex chromosome, testicular tumors, testicular damage, varicocele, which is an abnormal enlargement of the vein in the scrotum that drains blood from the testicles, disease-associated testicular damage, including from mumps, certain systemic diseases, such as renal insufficiency, and exposure alcohol in chronic excess.
- Secondary hypogonadism includes Kallmann Syndrome, a genetic condition within a group of conditions known as hypogonadotrophic hypogonadism caused by failure of hypothalmic release of gonadotrophin-releasing hormones, or can be illness-associated or caused by some medications, such as opioid or corticosteroid drugs. Secondary hypogonadism occurs at a significantly higher rate among men with diseases such as type 2 diabetes and its common precursor, metabolic syndrome. For example, one-third and 12% of all men with type 2 diabetes and metabolic syndrome, respectively, are hypogonadal, according to published research. Secondary hypogonadism is also associated with obesity, chronic heart disease, chronic renal disease, asthma and chronic obstructive pulmonary disease.