Definition
What is hypogonadism?
Hypogonadism is the medical term for clinically low testosterone in men. It is diagnosed when two morning blood tests confirm testosterone below the normal range and the man has matching symptoms. It is the formal label that sits behind the everyday phrase "low T".
Quick facts
- Everyday name
- Low testosterone / low T
- Primary cause
- Testicular failure
- Secondary cause
- Pituitary/hypothalamic failure
- Australian threshold
- <8 nmol/L total T
- Diagnosis requires
- 2 morning tests + symptoms
- Standard treatment
- TRT under specialist care
Primary vs secondary hypogonadism
Hypogonadism is split into two types based on where the problem sits in the hypothalamic-pituitary-gonadal axis.
| Primary | Secondary | |
|---|---|---|
| Location of problem | Testes | Pituitary / hypothalamus |
| Testosterone | Low | Low |
| LH / FSH | High | Low or inappropriately normal |
| Typical causes | Klinefelter, mumps, chemo, trauma, ageing | Pituitary tumour, opioids, obesity, head injury |
| Fertility-preserving options | Limited | hCG, gonadotrophins |
How hypogonadism is diagnosed in Australia
- Symptom screen (e.g. ADAM questionnaire).
- First morning blood test — total testosterone, SHBG, LH, FSH.
- Confirmation morning blood test on a different day.
- Pituitary work-up (prolactin, ferritin, MRI if indicated) for secondary cases.
- Specialist referral for PBS-subsidised treatment.
Related pages
Clinical sources
- [1]RACGP. Testosterone use in adult males — clinical guideline
- [2]Endocrine Society. Clinical practice guideline: testosterone therapy in men with hypogonadism
- [3]Healthdirect Australia. Testosterone: symptoms, causes and assessment
- [4]Endocrine Society of Australia · Medical Journal of Australia. Male hypogonadism position statement, part 1: assessment
People also ask
What does hypogonadism mean?+
Hypogonadism literally means "low gonadal function". In men it refers to inadequate testosterone production by the testes, confirmed by blood tests and accompanied by symptoms such as fatigue, low libido or infertility.
What is the difference between primary and secondary hypogonadism?+
Primary hypogonadism is testicular failure — the testes can't produce testosterone despite normal pituitary signalling. Secondary hypogonadism is a pituitary or hypothalamic problem — the testes are healthy but aren't being told to make testosterone.
Is hypogonadism the same as low testosterone?+
Hypogonadism is the formal medical diagnosis; low testosterone is the everyday term for the same condition. A hypogonadism diagnosis requires biochemical confirmation plus symptoms.
Can hypogonadism be cured?+
Some cases (caused by obesity, opioids or sleep apnoea) reverse when the underlying cause is treated. Primary hypogonadism from testicular damage usually needs lifelong testosterone replacement therapy (TRT).
Is hypogonadism a disability in Australia?+
Hypogonadism is recognised as a chronic medical condition. It is treatable and PBS-subsidised under specialist authority but is not classified as a disability under the NDIS in most cases.
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