Functional hypogonadism in obese male

This episode reviews functional hypogonadism in obese males tailored for practicing endocrinologists. The discussion explores adipokine-mediated hypothalamic-pituitary-gonadal axis suppression, aromatase hyperactivity converting testosterone to estradiol, central leptin resistance, and sleep apnea induced hypoxia. Listeners will review diagnostic criteria using liquid chromatography-tandem mass spectrometry and equilibrium dialysis alongside strategies to exclude structural lesions. Finally, the episode highlights weight reduction and bariatric surgery as primary reversible therapies, compares the off-label utility of selective estrogen receptor modulators and aromatase inhibitors for fertility preservation, and outlines safety monitoring protocols for testosterone replacement therapy.