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: The Effect of 5-Alpha Reductase on Testosterone in Men

Eligibility criteria:
Inclusion Criteria

          -  General good health and capable of undergoing strength testing

          -  Normal testosterone (300-1100 ng/dL), LH, and FSH levels

        Exclusion Criteria

          -  Currently participating in competitive sports

          -  Mental state that would preclude complete understanding of the protocol and compliance

          -  Disorder known to cause or be associated with hypogonadism (e.g., pituitary tumors,
             hyperprolactinemia, HIV infection, or Klinefelter's Syndrome)

          -  More than 20% over ideal body weight

          -  Disabilities that would prevent participation in strength testing (e.g., amputation of
             limbs, blindness, severe arthritis, angina, or neurologic disorders such as
             Parkinson's disease, stroke, or myopathy)

          -  Uncontrolled hypertension, diabetes, congestive heart failure, or chronic obstructive
             lung disease

          -  Alcohol or drug dependence in the 6 months prior to study entry

          -  Disorders that might be exacerbated by androgen treatment (e.g., benign prostatic
             hyperplasia or prostate cancer, erythrocytosis [hematocrit > 51% at baseline], or
             sleep apnea assessed by Berlin's questionnaire)

          -  Serum PSA levels > 4 microg/L

          -  AST, ALT, or alkaline phosphatase elevation greater than three times the upper limit
             of normal

          -  Creatinine greater than 2 mg/dL

          -  Medications that might affect muscle or bone metabolism (e.g., glucocorticoid, rhGH,
             androgenic steroids, oral androgen precursors such as androstenedione or DHEA) or
             androgen metabolism, action, or clearance (e.g., dilantin, phenobarbitol, aldactone,
             flutamide, finasteride)
Male
Accepts Healthy Volunteers
Subject must be at least 21 Years old.
Subject must be at most 40 Years

Eligibility (NLI label): Contradiction