Symptoms of Testosterone Deficiency

The symptoms of testosterone deficiency are not that obvious, which leads to many patients not knowing that they have this disease in the early stages. However, this condition still has a great impact on the patient's future health. The most important thing is that it will cause abnormal embryonic development in male friends. This problem causes male friends' sexual reproductive organs to develop poorly and cause sexual dysfunction.

The physiological characteristics of testosterone mainly include the following five aspects:

① Affects embryonic development and promotes the growth and development of male accessory organs. Testosterone can stimulate the growth and development of accessory organs such as the prostate, penis, scrotum, and bulbourethral glands;

② Stimulate the growth of reproductive organs and the appearance of secondary sexual characteristics. Testosterone can stimulate and maintain the collection and organization of male secondary sexual characteristics, and can also produce and maintain normal sexual desire;

③Maintain spermatogenesis. After testosterone is secreted from interstitial cells, it can enter the seminiferous tubules through the basement membrane, bind to the corresponding receptors of spermatogenic cells, and promote spermatogenesis;

④Affect metabolism. Testosterone can promote protein synthesis, especially protein synthesis in muscles and bones; affect water and salt metabolism, which is beneficial to the retention of water and sodium in the body; increase calcium and phosphorus deposition in bones; ⑤In addition, testosterone can stimulate the production of red blood cells, increasing the number of red blood cells in the body.

Abnormal physiological functions will lead to abnormal blood testosterone concentrations.

Differential diagnosis of confusing symptoms of low blood testosterone

(1) XX male syndrome: The autosomal chromosome is XX, with no Y chromosome. HY antigen can be detected in the serum, indicating that a small amount of Y is embedded in the X or autosome, which cannot be found in vitro. The phenotype is male, and the incidence rate in male infants is 1:20,000-24,000. The patient lacks all female internal reproductive organs and has male sexual psychological characteristics.

Clinical manifestations are similar to Klinefelter syndrome: small and hard testicles (generally less than 2 cm), often with male breast development, normal penis size or slightly smaller than normal adults, usually with azoospermia and hyaline degeneration of the seminiferous tubules. Blood testosterone levels are reduced, estradiol levels are increased, and gonadotropin levels are increased. Clinically, this type is similar to XXY/XY mosaicism. The patient is short in stature, and intellectual disability and personality changes are very mild and relatively rare. The incidence of hypospadias is increased.

(2) Male Turner syndrome: autosomal dominant inheritance, karyotype 46,XY, with typical clinical manifestations of Turner syndrome: short stature, webbed neck, cubitus valgus, congenital heart disease, and male phenotype. There are often cryptorchidism, shrunken testicles, dysplastic vasculature, sexual immaturity, decreased blood testosterone, and increased serum gonadotropin levels. A small number of patients have normal testicles and are fertile.

Leydig cell dysplasia: Testosterone secretion disorder of fetal stromal cells, resulting in male pseudohermaphroditism. There are testicles but spermatogenesis disorder. Vulvar malformation, female phenotype, penis similar to clitoris, with blind vagina, but no uterus and fallopian tubes, and primary amenorrhea is not discovered until puberty. Pubic and axillary hair are sparse. The patient's FSH and LH baseline values ​​are elevated, the GnRH test gonadotropin response is obvious, blood testosterone is significantly low, and HCG stimulation does not increase.