A 31 yr old male was diagnosed with hypogonadism 5 yrs back, on testosterone replacement therapy on and off, now presently complains of lack of interest, decreased verbal fluency, loss of libido, poor judgement, his serum T 154 ng/dl, LH 4.5. Initially, after testosterone shots pt had a sense of well-being, positive mood but after few days signs of depression started again. How to go ahead?
Further management? Other biochemical markers are normal, is it really hypogonadism or over treated? Thanks.
