Central hypogonadism

• Clinical manifestations: ↓ libido, impotence, oligomenorrhea or amenorrhea, infertility, ↓ muscle mass, osteoporosis
• Physical exam: ↓ testicular size; loss of axillary, pubic and body hair
• Dx with: ↓ a.m. testosterone or estradiol (also assess SHBG, esp. in obese) and ↓ or normal FSH/LH (all levels ↓ in acute illness, ∴ do not measure in hospitalized Pts)
• Treatment: testosterone or estrogen replacement vs. correction of the underlying cause