What causes TDS?

TDS or hypogonadism is caused either when the testicles do not function normally or when internal hormone production is out of balance. TDS can affect men of any age. Causes can be ²⁵:

• Genetic – e.g. Klinefelter's syndrome
• Congenital – e.g. Anorchia (absence of testes)
• Secondary – e.g. Pituitary tumour
• Age-associated – e.g. mixture of reduced testicular testosterone production and pituitary function

Primary TDS refers to low testosterone resulting from a problem within the testes. This may be due to a genetic cause, such as Klinefelter’s syndrome, or due to physical damage to, or removal of, one or both of the testes. Illnesses such as mumps, cancer, liver or kidney disease and diabetes can also affect the testes and cause primary hypogonadism.

Secondary TDS results when the system that produces male sex hormones is imbalanced or breaks down. A breakdown or imbalance at any point in the hormone cascade can lead to a reduced level of testosterone.

It has been shown that over a third of men with erectile dysfunction (ED) may also have TDS ¹⁷ and this could be higher in patients with both ED and Type 2 Diabetes ²⁶.

It is also becoming more widely recognised that many men will develop TDS, also known as late onset hypogonadism (LOH), simply as a result of advancing age ⁵⁰.