Editing Testosterone Deficiency (2018) (section)

=== History and Physical Exam ===

==== History ====
* '''<span style="color:#ff0000">Signs and symptoms</span>'''
**'''<span style="color:#ff0000">Categories (3):</span>'''
**# '''<span style="color:#ff0000">Physical</span>'''
**#* '''Loss of body hair, reduced lean muscle mass, gynecomastia'''
**#* '''Fatigue'''
**#* '''Visual field changes (bitemporal hemianopsia), anosmia (loss of smell)'''
**# '''<span style="color:#ff0000">Cognitive</span>'''
**#* '''Depression'''
**#* '''Cognitive dysfunction, poor concentration, poor memory'''
**#* '''Irritability'''
**# '''<span style="color:#ff0000">Sexual</span>'''
**#* '''Erectile dysfunction, decreased libido'''
**#* '''Infertility/difficulty conceiving'''
**'''Many of the symptoms are non-specific (e.g. fatigue) and might be related to conditions other than low testosterone.'''
* '''<span style="color:#ff0000">Risk factors for AD (see above)</span>'''
**'''Past medical history'''
**'''Past surgical history'''
**'''Medications'''

==== Physical exam ====
# '''<span style="color:#ff0000">General</span>''' 
##'''<span style="color:#ff0000">Body habitus</span>''' (BMI or waist circumference)
## '''<span style="color:#ff0000">Virilization status</span>''' (body hair patterns and amounts in androgen dependent areas)
## '''<span style="color:#ff0000">Presence of gynecomastia</span>'''
##* Gynecomastia is a benign enlargement of the male breast tissue that can occur at times of male androgen/estrogen change (alteration in testosterone/estradiol [E2] ratio) such as infancy, adolescence, or old age, and may also be a sign of low serum testosterone.
##** '''Male breast growth can be classified as (3):'''
##**# '''Pharmacological''' (risperidone, anti-androgens, marijuana, clomiphene)
##**# '''Physiological (neonatal period and at puberty)'''
##**# '''Pathological (testicular tumours, Klinefelter syndrome, cirrhosis)'''
##** '''With any enlargement of the male breast, the possibility of carcinoma should be considered.'''
# '''<span style="color:#ff0000">Genitals</span>'''
#* '''Testicular size, consistency'''
#*'''Presence of varicoceles'''
#**'''No definitive evidence that varicocele is a cause of low testosterone, however, varicocele ligation surgery might increase serum testosterone levels'''