Case Reports and Reviews: Open Access

Abstract 

Background: In our study, we focused on a group of young patients with a testosterone level below the average values of the standard for a prolonged period and the changes in the hypothalamic-pituitary-gonadal axis. Methods: From January 2013 to December 2019 at the Andrological office we examined 73 men aged 37 to 45 years with normal or elevated body mass index and a testosterone level below the average values of the standard for a prolonged period. We selected a control group of 20 agematched men. Results: In the patients, we obtained, although within reference limits, reliably lower values for total serum testosterone compared to those of the control group (p<0.001). We found significant differences in mean levels of sex hormone binding globulin, estradiol, luteinizing and follicle stimulating hormones, estradiol/testosterone ratio, and the free androgen index values between the study men and those of the control group (p<0.001). Conclusions: Our studies unequivocally show that even at a young age, some men, regardless of their BMI, have certain deviations in the normal secretion of testosterone and its carrier in the blood. Along with that, changes in the hypothalamic-pituitary-gonadal axis were observed, which, although not yet out of the reference values, differed significantly from the same parameters in their peers with a high degree of normality the serum testosterone level. The changes we have found are mostly discrete, probably reversible with lifestyle changes, but if ignored can lead in older age to a prominent climacteric-like state and hypogonadism. 

Keywords: Testosterone, Estradiol, FAI, E2/T ratio, LH, FSH, Joung mem.