There is a group of middle-aged men with sexual dysfunction that presents reduced serum testosterone levels and normal to low levels of prolactin and gonadotropins, but without any dermonstrable hypothalamicpituitary anatomic abnormality. This condition is considered a form of idiopathic hypogonadotropic hypogonadism, probably of hypothalamic origin. We present and discuss two patients with similar features in whom sexual dysfunction preceded actual hypoandrogenism. We conclude that in these two patients hypoandrogenism was the consequence of a psychoneuroendocrine disturbance due to the sexual dysfunction.
Hypogonadotropic hypogonadism; Sexual dysfunction; Hypoandrogenism; Stress; Clomiphene
