Testicular Deficiency Due to Hypothyroidism
The following case is presented to show the relationship of excreted androgens to various symptoms, including impotence, and because it appears to illustrate a relationship between hypothyroidism and the excretion of androgenic materials. The urinary androgens in all probability reflect fairly accurately the degree of hypogonadism which is present.
History: A white man, 50 years of age, was examined first in June, 1936. He complained of gradually increasing impotence and loss of sexual libido over a period of 18 months. There had been no infections of the genito-urinary tract in the immediate past or previously, no orchitis, and no severe general infections. His symptoms apparently could not be ascribed to exhaustion, since they had not improved following vacations and adequate rest. For six months impotence had been almost complete and no ejaculations had occurred under any circumstances. Energy and endurance were fairly good. He tended to be rather irritable, but otherwise there were no nervous symptoms and none suggestive of hypothyroidism.
The physical examination revealed an alert, healthy-looking man whose height was 73 inches and weight 166 pounds. His temperature was normal. The pulse rate ranged between 65 and 80 beats per minute. His skin was very slightly dry, although the color of the skin and the mucous membranes was good. He had a slight gingivitis. The blood pressure was 115 systolic and 80 diastolic. The prostatic secretion contained from 10 to 20 white blood cells per high power field and appeared normal. The prostate and the genitalia were apparently. . .