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Secondary male hypogonadism — SCE Endocrinology MCQ

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ModeratePituitarySecondary male hypogonadismSCE Endocrinology

A 62-year-old man has low testosterone on two morning samples with low LH and FSH. He has untreated severe obstructive sleep apnoea and haematocrit 0.55. What is the most appropriate management before testosterone therapy?

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Correct answer: B — Address contraindications and investigate secondary hypogonadism

Testosterone therapy requires confirmation of hypogonadism, cause assessment and review of contraindications such as high haematocrit and untreated severe sleep apnoea. Starting treatment immediately may worsen erythrocytosis. Secondary hypogonadism should prompt prolactin and pituitary evaluation where indicated.

Reference: Endocrine Society Testosterone Therapy Guideline; BNF