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: Safety of Subcutaneous Testosterone Enanthate in Adult Male Hypogonadism

Eligibility criteria:
Inclusion Criteria

        Each patient must meet all of the following criteria at screening to participate in the
        study:

          1. The patient is 18 years of age or older;

          2. The patient speaks, reads, and understands the English language at a sixth grade
             reading level or higher;

          3. The patient is willing to have photographs taken and/or be video recorded while he
             completes study tasks, which will be de-identified prior to any potential use of the
             image(s) for scientific or educational purposes;

          4. The patient has sufficient availability to participate in the study and to comply with
             the study schedule;

          5. The patient has his own transportation to and from the study site;

          6. The patient demonstrates the ability to understand and the willingness to follow all
             study instructions; and

          7. The patient has read, stated he understands, and has signed the Informed Consent Form
             (ICF).

          8. The patient has been diagnosed with hypogonadism;

          9. The patient is a male;

         10. The patient has a documented history of hypogonadism. Diagnosis must include
             documentation of consistent signs and symptoms of androgen deficiency;

         11. Patients in good health as determined by the Investigator and based on medical
             history, physical examination, vital signs, electrocardiogram (ECG), and clinical
             laboratory tests;

         12. All male patients must practice effective contraception during the study and for 30
             days after receiving the last dose of study drug. Acceptable methods of birth control
             include condom with spermicide, vasectomy, or monogamous relations with a female
             partner who is of non child-bearing potential (post-menopausal, surgical, or
             congenital sterility) or is of child bearing potential and practicing a reliable
             method of contraception (hormonal contraception, double barrier methods with
             spermicide, or intrauterine device); and

         13. Patients must have the ability to provide written informed consent and comply with all
             study requirements and restrictions including the study visit schedule.

        Exclusion Criteria

        Patients will be excluded from participation in the study if any of the following criteria
        apply:

          1. Failure to meet 1 or more Inclusion Criterion;

          2. The patient has participated in interviews, focus groups, or studies for any medical
             products or therapies within the past 3 months or in a prior QST auto-injector
             usability study, clinical trial, and/or has previous exposure to the investigational
             device;

          3. The patient or someone he lives with works or has worked for a Marketing/Market
             Research Company, pharmaceutical or medical device company, a manufacturer,
             distributor, or wholesaler of non-prescription drug products, or a government health
             agency;

          4. Individuals who have had an allergic reaction or idiosyncratic reaction to sesame
             seeds, sesame products, and/or sesame oil;

          5. History of food anaphylaxis;

          6. History of intolerance, allergy, or idiosyncratic reaction to testosterone products;

          7. Unstable psychiatric illnesses;

          8. Lifetime history of psychosis, suicidal behavior, bipolar disorder, or personality
             disorder; active suicidal ideation within 6 months prior to screening; or inadequately
             treated depression. Note: Patients with depression who have been adequately treated
             and with stable response for 3 months may be admitted into the study at the
             Investigator's discretion;

          9. Body mass index 40 kg/m2;

         10. Hematocrit 52% at Initial Screening Visit;

         11. Individual history or current evidence of breast or prostate cancer;

         12. Other malignancy diagnosed or treated within 5 years of the date of Initial Screening
             Visit with the exception of non-melanoma carcinoma of the skin;

         13. Elevated prostate-specific antigen (PSA) for age. Prostate-specific antigen 2.5 ng/mL
             in men 18 to 60 years old and 4 ng/mL in men 61 years and older is exclusionary;

         14. Presence of prostate nodule or induration upon digital rectal exam;

         15. Obstructive uropathy of prostatic origin and of a severity that, in the opinion of the
             Investigator, contraindicates the use of testosterone;

         16. Patients with poorly controlled diabetes. Patients on a stable dose and regimen of
             anti diabetic medications for a minimum of 4 weeks, and who have a hemoglobin A1c
             level of 7.5% may participate in the study;

         17. Patients with New York Heart Association Class III or IV congestive heart failure;

         18. Within 6 months of the Initial Screening Visit, have had myocardial infarction,
             unstable angina leading to hospitalization, percutaneous coronary intervention,
             coronary artery bypass graft, uncontrolled cardiac arrhythmia, stroke transient
             ischemia attack, carotid revascularization, endovascular procedure, or surgical
             intervention for peripheral vascular disease;

         19. History of, or current treatment for, thromboembolic disease or current use of anti
             thromboembolic medications. Use of low-dose aspirin is permitted for routine
             cardioprophylaxis;

         20. Patients intermittently taking adrenocorticotropic hormone, oral, or depot
             corticosteroids (ongoing regimens required for panhypopituitarism or adrenal failure
             are permitted);

         21. Untreated sleep apnea;

         22. Historical or current evidence of any clinically significant disease or disorder that,
             in the judgment of the Investigator, may cause participation in this study to be
             detrimental to the patient or which may influence the results of the study. This
             includes cardiovascular, renal, hepatic, hematological, endocrine, gastrointestinal,
             or pulmonary disease;

         23. Positive serology for human immunodeficiency virus antibodies, hepatitis B surface
             antigen, or hepatitis C virus antibody at the Initial Screening Visit;

         24. Current evidence of alcohol or drug abuse. A positive drug screen is exclusionary
             without documentation of a current prescription and medical condition requiring
             treatment with the drug for which the screen is positive. Exception:
             tetrahydrocannabinol is allowed in states where recreational use of marijuana is
             legal;

         25. Any skin condition that could confound injection site assessments (eg,
             dermatographism, urticaria, or atopic dermatitis). Tattoos, scarring, or psoriasis of
             the injection site is prohibited;

         26. Administration of any other investigational compound within 1 month prior to Initial
             Screening Visit or 5 half-lives of the investigational product (whichever is longer);

         27. Patients considering or scheduled to undergo any major surgery or dental procedure
             anticipated to be associated with significant blood loss (500 mL) during the study;

         28. Systolic blood pressure (SBP) 140 mmHg and/or diastolic blood pressure (DBP) 90 mmHg
             at the Initial Screening Visit. Patients with treated hypertension and SBP 140 and/or
             DBP 90 mmHg at the Initial Screening Visit must be on a stable dose of
             antihypertensive medication for at least 14 days at Day -1 (Baseline Visit) and plan
             to remain on the same dose throughout the duration of the study; or

         29. Unable to understand verbal or written English or any other language in which a
             certified translation of the informed consent is available.
Male
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment