Testosterone deficiency: Target populations and suggestive clinical signs

Testosterone deficiency (TD) is defined by clinical signs suggestive of this deficiency, confirmed by a biological assay of the testosterone level or the activity of serum androgens. We will not discuss congenital hypogonadisms, which are related to a more directly endocrinological problem. During aging in men, a number of authors have described signs suggesting a decrease in testosterone such as a decrease in libido, erections, mental and physical fatigue, pleasure and ejaculation disorders, the onset of gynecomastia, decreased muscle mass and increased fat mass, testicular involution and sometimes osteoporosis. Among all these symptoms, many relate to the sexual sphere and challenge the sexologist. In addition, certain pathological situations such as diabetes, metabolic syndrome, cardiovascular disease, overweight, taking opioids, anticonvulsants, antiretrovirals, ineffectiveness or secondary loss of effectiveness of Ipde5 are circumstances that should lead to the search for a TD. It seemed useful to us to take stock of the risk situations for TD and the clinical signs that should alert the sex therapist. We will not go over the biological assays, which will be developed in the next chapter. (C) 2021 Published by Elsevier Masson SAS on behalf of Sexologies.