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Functional hypogonadism among patients with obesity, diabetes, and metabolic syndrome

International Journal of Impotence Research volume 34, pages 714–720 (2022)Cite this article

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Abstract

Testosterone deficiency, defined as low total testosterone combined with physical, cognitive, and sexual signs and/or symptoms, is a common finding in adult men. Functional hypogonadism (FH) is defined as borderline low testosterone (T) secondary to aging and/or comorbid conditions such as diabetes, obesity, and/or metabolic syndrome. The relationship between FH and metabolic disorders is multifactorial and bidirectional, and associated with a disruption of the hypothalamic–pituitary–gonadal axis. Resolution of FH requires the correct diagnosis and treatment of the underlying condition(s) with lifestyle modifications considered first-line therapy. Normalization of T levels through dietary modifications such as caloric restriction and restructuring of macronutrients have recently been explored. Exercise and sleep quality have been associated with T levels, and patients should be encouraged to practice resistance training and sleep seven to nine hours per night. Supplementation with vitamin D and Trigonella foenum-graecum may also be considered when optimizing T levels. Ultimately, treatment of FH requires a multidisciplinary approach and personalized patient care.

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Fig. 1: Relationship between hypogonadism and metabolic disorders.

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Authors and Affiliations

  1. Department of Urology, University of Michigan, Ann Arbor, MI, USA

    Marne Louters

  2. Division of Digestive and Liver Diseases, University of Miami, Miami, FL, USA

    Michelle Pearlman

  3. Carver College of Medicine, University of Iowa, Iowa City, IA, USA

    Emily Solsrud

  4. Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Amy Pearlman

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  1. Marne Louters
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ML was responsible for the literature review and writing of the review article. AP created an outline for the review article, edited the review article, and provided an expert opinion. MP provided expert opinion and edited the review article. ES provided feedback on the review article and assisted with figure creation.

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Correspondence to Marne Louters.

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Louters, M., Pearlman, M., Solsrud, E. et al. Functional hypogonadism among patients with obesity, diabetes, and metabolic syndrome. Int J Impot Res 34, 714–720 (2022). https://doi.org/10.1038/s41443-021-00496-7

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