Paediatric and adult-onset male hypogonadism

Andrea Salonia, Giulia Rastrelli, Geoffrey Hackett, Stephanie B. Seminara, Ilpo T. Huhtaniemi, Rodolfo A. Rey, Wayne J.G. Hellstrom, Mark R. Palmert, Giovanni Corona, Gert R. Dohle, Mohit Khera, Yee Ming Chan, Mario Maggi

Research output: Contribution to journalReview articlepeer-review


The hypothalamic–pituitary–gonadal axis is of relevance in many processes related to the development, maturation and ageing of the male. Through this axis, a cascade of coordinated activities is carried out leading to sustained testicular endocrine function, with gonadal testosterone production, as well as exocrine function, with spermatogenesis. Conditions impairing the hypothalamic–pituitary–gonadal axis during paediatric or pubertal life may result in delayed puberty. Late-onset hypogonadism is a clinical condition in the ageing male combining low concentrations of circulating testosterone and specific symptoms associated with impaired hormone production. Testosterone therapy for congenital forms of hypogonadism must be lifelong, whereas testosterone treatment of late-onset hypogonadism remains a matter of debate because of unclear indications for replacement, uncertain efficacy and potential risks. This Primer focuses on a reappraisal of the physiological role of testosterone, with emphasis on the critical interpretation of the hypogonadal conditions throughout the lifespan of the male individual, with the exception of hypogonadal states resulting from congenital disorders of sex development.

Original languageEnglish
Article number38
JournalNature Reviews Disease Primers
Issue number1
Publication statusPublished - Dec 1 2019

ASJC Scopus subject areas

  • Medicine(all)


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