Andrologist, Urologist

Testosterone and Testosterone deficiency syndrome

What is testosterone ?

Testosterone is the male hormone which helps in the physical, sexual and psychological well being of the person.

What is the role of testosterone hormone in male body ?

Testosterone helps in development of male secondary characters at puberty such as growth of facial hairs, penis and testes enlargement, deepening of voice, bony and muscle growth etc. In grown adults, this hormone helps in maintaining muscle and fat mass, safeguarding cardiovascular health and producing blood cells, keeping emotional stability, maintaining sexual life while keeping libido, sexual desire, penile erection and fertility normal.

What are sign and symptoms of testosterone deficiency in men ?

Sexual symptoms – Decreased libido; erectile dysfunction; decreased frequency of
morning erections; decreased performance

Physical symptoms – Increased visceral body fat/obesity; decreased lean muscle mass;
decreased strength; fatigue/loss of energy; decreased physical activity/
vitality; low bone mineral density; anemia; flushes; loss of facial, axillary
and pubic hair/slow beard growth; decline in general feeling of well-being

Psychological symptoms – Depression/depressed mood; mood changes; irritability;
inability to concentrate; insomnia/sleep disturbances

Which persons are at risk of developing testosterone deficiency syndrome ?

Persons with poorly controlled diabetes, high BMI, kidney failure on dialysis, chronic alcohol consumer, liver disease, on cancer chemotherapy , drug addicts, COPD etc are at risk for testosterone deficiency and its symptoms.

How to check and evaluate for the testosterone deficiency ?

Testosterone is checked by the blood sample, taken in fasting state early morning between 8 am to 11 am. Normal levels of total testosterone in adult male is usually between 275 ng/dl – 875 ng/dl. Level below this range suggests testosterone deficiency.

How to treat if someone having low testosterone levels ?

If someone is having low serum testosterone levels, complete history and examination for sign and symptoms is must for such patients, as only low testosterone levels does not warrants its treatment. If there are corroborative sign and symptoms along with low testosterone level, the treatment is usually initiated with either intramuscular (i.m.), oral and gel preparations.

Whom to consult for if someone has low testosterone levels ?

You should meet Andrologist for the evaluation and treatment of low testosterone levels.

Andrologist, Urologist

Ten signs and symptoms of low testosterone levels in adults

  1. Sexual symptoms – Most prominent symptom, Decreased erections, loss of erectile function (erectile dysfunction), decreased semen volume, decreased frequency of ejaculations
  2. Hair loss
  3. Cognitive symptoms – Low mood, low sexual desire, memory impairement, sleep disturbances, concentration difficulties, decreased motivation
  4. Reduced muscle mass, increase in body fat
  5. Decreased physical strength/activity, decreased energy
  6. Increased risk of heart diseases
  7. Hot flushes
  8. Gynecomastia/increased breast tissue
  9. Persistent fatigue
  10. Loss of bone tissue, increased risk of osteoporosis

Read more about testosterone and testosterone deficiency syndrome at Testosterone and Testosterone deficiency syndrome

Andrologist, Urologist

Absent testes in scrotum or empty scrotum (Undescended Testes/ Cryptorchidism)

  • Absence of either testis from its normal position in scrotum is called undescended testis.
  • It is most common congenital abnormality found in male genitalia.
Undescended testis (Cryptorchidism)


  • Congenital – Undescended testis present since birth
  • Acquired – testis which has migrated up that has been previously noted to be present in scrotum
  • Location wise – Inguinal (groin), Intra-abdominal, Ectopic (not in path of normal descent)

Causes of undescended testis

  • Developmental disorder of the gonads by either environment or genetic factors.
  • Maternal smoking
  • Premature birth

Effects of undescended testes

  • Undescended testis of one side can affect the function of normally descended other testis also.
  • Impaired semen parameters
  • Impaired fertility
  • Hypogonadism (testosterone deficiency)
  • Tumors in the undescended testis


  • Surgical treatment is mainstay of management.
  • In infants and early age, surgical correction with bringing testis down into scrotum is done.
  • In adults with intra-abdominal testis, and having normal opposite testis, orchiectomy is usually considered. However if both testes are intra-abdominal, surgical correction to bring testes down into scrotum is considered.