What Is Compensated Hypogonadism?

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Compensated hypogonadism is a subclinical type of late-onset hypogonadism, a condition where the sex organs or gonads stop producing sufficient levels of sex hormones. It is estimated to affect 9.4% of aging men.

This condition seems to occur independently of obesity and may be characterized by symptoms of impotence and erectile dysfunction or present with little or no symptoms.

In the last few years, researchers have begun looking more closely at subclinical endocrine disorders, like compensated hypogonadism, because they have been found to be a marker of poor health that may be predictive of other more serious conditions such as heart disease.

This article will discuss symptoms associated with compensated hypogonadism and causes, how the condition is diagnosed, and treatment options.

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What Is Compensated Hypogonadism?

Compensated hypogonadism (CH) is also known as testosterone deficiency associated with age. This is due to a failure of the testes (testicles) to produce higher amounts of the male sex hormone testosterone.

Reproductive health as well general health in males relies on having balanced levels of androgens (male sex hormones, such as testosterone) and other hormones, which are mainly produced by specialized testes cells (Leydig and Sertoli cells).

As people age, these testes' cells become less responsive to luteinizing hormone (LH), a pituitary hormone that tells the testes to make testosterone. Typically, people with CH have elevated levels of LH, because LH is not being used efficiently.

Androgens, including testosterone, have many important functions in the body, such as promoting muscle growth, stimulating arousal, and influencing cognitive function. That means when CH develops, it can cause a wide range of symptoms.

Symptoms of CH

The signs and symptoms that people with compensated hypogonadism might experience will depend on when the deficiency starts and for how long, its severity, and whether or not there is a decrease in the major functions of the testes. 

Many people who have CH experience no significant symptoms, while others present with one or more of the following symptoms:

What Causes Compensated Hypogonadism?

The reasons that CH develops are poorly understood, but some experts believe it may be related to overall declines in health.

One recent study found that people with CH were also more likely to have mobility issues, lower cognitive function, poor nutritional status, and blue moods than those with normal hormone levels. Another study found that a correlation between vitamin D deficiency and increased risk of CH.

However, unlike other types of hypogonadism, CH is not associated with lifestyle risk factors, including obesity, smoking, or alcohol use.

How CH Is Diagnosed

If you are struggling with symptoms of compensated hypogonadism, it's important to consult a healthcare provider. At your appointment, a healthcare professional will do a physical exam, looking for any abnormalities in your sex organs. They will also order bloodwork.

A CH diagnosis is made based on a blood test looking at your hormone levels. CH is characterized by normal testosterone levels with high levels of LH. According to the European Male Aging Study, CH is marked by a normal serum testosterone level of 10.5 nanomoles per liter (nmol/L), but a serum LH value above 9.4 international units per liter (IU/L).

How CH Is Treated

While some types of hypogonadism are treated with synthetic testosterone, there is currently no indication that testosterone therapy has sufficient benefit for those with compensated hypogonadism. 

Your healthcare provider can help you weigh any potential benefits of testosterone therapy with the risks (such as increased risk of prostate cancer, although still controversial) based on your overall health and symptoms.

Instead, most management strategies for CH include the adoption of healthy lifestyle habits, such as exercising regularly, eating a nutritious diet, reducing stress, and getting enough sleep.

Prognosis: Coping With CH Long-Term

Hypogonadism is a marker of poor health and increased mortality risk, so a diagnosis should be taken seriously. You'll want to work with your healthcare provider on strategies to improve your overall health.

The European Male Aging Study found that after four years of prospective follow-up, participants with compensated hypogonadism were three times more likely to have died compared to men who did not have any type of hypogonadism. People with CH also had nearly twice the mortality rate as those with other types of hypogonadism, such as secondary hypogonadism, or hypogonadotropic hypogonadism. 

Summary

Compensated hypogonadism is a subclinical deficiency of the male sex hormone testosterone. It is mainly caused by factors related to age. Symptoms made include erectile dysfunction, low moods, shrinking muscle mass, and fatigue. This condition can be diagnosed with a hormone blood test. Currently, there are no recommended treatments aside from adopting healthy habits, such as exercising, eating a healthy diet, and managing stress levels.

A Word From Verywell

Compensated hypogonadism is fairly common, but it is not a straightforward diagnosis. Not only does CH present with little to no symptoms, but there are many factors related to health alterations in old age that may cause large fluctuations in testosterone levels.

As a result, treatment options for CH are limited at best. While studies have demonstrated some positive effects of testosterone therapy, the clinical meaningfulness of these findings remains debatable. Your best bet for coping with CH is to take measures to improve your overall health. Get out for daily walks in the sun, cook up colorful, vegetable-rich meals, or take up a new hobby.

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