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Clinical appearance and examination 

Clinical appearance and examination
Chapter:
Clinical appearance and examination
Author(s):

Eberhard Nieschlag

DOI:
10.1093/med/9780199235292.003.9034
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date: 11 December 2019

While infertility as such is usually not accompanied by any characteristic clinical appearance of the patient, depending on the degree of testosterone deficiency, hypogonadism leads to distinct symptoms, which—if fully expressed—can be easily recognized. Testosterone is necessary throughout life and creates identifiable phenotypical expressions in the various phases of life.

The onset of lack of testosterone can be estimated from the clinical appearance of the patient. Concerning clinical symptomatology, some androgen-determined phenotypical features require continuous androgen action (for example, beard growth, haematopoiesis, and libido), while others, once induced by testosterone, may be maintained without the continuous support of testosterone (for example, size of larynx and penis). Intrauterine lack of testosterone at the time of sexual differentiation may lead to various disorders of sexual differentiation (DSD). Postnatally, the clinical appearance of hypogonadism depends on whether the lack of testosterone becomes manifest before or after puberty (Table 9.3.1.1). While lack of testosterone before and during puberty may lead to the full picture of eunuchoidism, after regular completion of puberty its symptoms may remain relatively hidden.

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