Patient case (clinical description): A 19-year-old male came to clinic with some sexual concern.  He recently engaged in a relationship and is worried about the satisfaction of his girlfriend. He has a "baby face" according to his girlfriend's statement and he is not as muscular as his classmates.  On physical examination, there is some pubic hair and poorly developed secondary sexual characteristics. He is unable to detect coffee smell during the examination, but the visual acuity is normal. Ultrasound reveals the testes volume of 1-2 ml. The hormonal evaluation showed serum testosterone level of 65 ng/dL with low levels of GnRH.

Patient's own account: I'm 19 years old guy and I just went to see a doctor at the clinic after I just got with my girlfriend. I'm kinda worried because she thinks that I have a baby face and to be honest, I'm way less muscular than my classmates. I don't have much hair down there, and yes, I don't have that macho look. The doctor made me smell some coffee and I couldn't smell anything special. I also had some eyesight checkups and the doctor told me everything was normal. I got my test results back and it says: testes volume is 1-2 ml and serum testosterone level of 65 ng/dL with low GnRH levels.

Clinical trial: Testosterone Replacement in Men With Diabetes and Obesity

Eligibility criteria:
Inclusion Criteria:

          -  T2D arm: Males with age 30-65 years

          -  Obese non-diabetic arm: Obese non-diabetic males with age 30-65 years

        Exclusion Criteria:

        1)Coronary event or procedure(myocardial infarction, unstable angina, coronary artery
        bypass, surgery or coronary angioplasty) in the previous twelve weeks; 2) PSA > 4ng/ml;
        3)Hemoglobin A1c > 8%; 4)h/o prostate carcinoma; 5)Hepatic disease (transaminase > 3 times
        normal) or cirrhosis; 6)Renal impairment (defined as GFR<30); 7)HIV or Hepatitis C positive
        status; 9)Participation in any other concurrent clinical trial; 10)Any other
        life-threatening, non-cardiac disease; 11)Use of over the counter health supplements which
        contain androgens; 12)Use of an investigational agent or therapeutic regimen within 30 days
        of study; 13)prostate nodule or severe enlargement on digital rectal examination; 14)Use of
        testosterone currently or in the past 4 months; 15)Hematocrit > 50%; 16)History of
        untreated severe obstructive sleep apnea(defined as apnea-hypopnea index ≥30); 17)symptoms
        suggestive of severe BPH; 18)Congestive heart failure, class III or IV; 20)Known to have
        anemia secondary to iron, B12 or folic acid deficiency; 21)bone marrow disorder such as
        myelodysplasia or aplastic anemia; 22) currently suffering from symptomatic depression,
        with or without treatment; 23) history of severe depression in the past which needed
        hospitalization; 24)currently suffering from foot ulcer, significant periodontal disease or
        any other chronic infectious condition; 25)planning to have children. 26) Subjects on
        testosterone or with testosterone replacement in the past 4 months will be excluded.
Male
No healthy subjects accepted to join the trial.
Subject must be at least 30 Years old.
Subject must be at most 65 Years

Eligibility (NLI label): Contradiction