A Working Group on low testosterone in overweight and obese men: is it a good idea to suppress LH with testosterone replacement therapy in asymptomatic men?

The relationship between serum testosterone and luteinizing hormone (LH) levels in male patients. Source: Dutta, 2017.


Last update and review: November 27, 2020.


Low total testosterone and normal LH are a common hormonal profile in overweight and obese men. But do those men have symptoms of hypogonadism? Are they symptomatic before they learn their testosterone is “low”?

Below, there is a table with hormonal profiles of a group of overweight and obese men from a 2019 study by Pearce and colleagues. We can see that low testosterone and normal LH are a common profile in overweight and obese men.

Baseline values for testosterone, LH, FSH. Source: Pearce and colleagues*. For: "Low testosterone in overweight men: why luteinizing hormone does not go up to compensate?"
Baseline values for testosterone, LH, FSH. Source: Pearce and colleagues*. For: “Low testosterone in overweight men: why luteinizing hormone does not go up to compensate?”

Indeed, if overweight or obese men have no symptoms of hypogonadism, further alteration of their hormonal profile with a testosterone replacement therapy is a questionable decision.

The graph below illustrates differences in testosterone and LH between eugonadism, compensated hypogonadism, primary hypogonadism and secondary hypogonadism.

The relationship between serum testosterone and luteinizing hormone (LH) levels in male patients. Source: Dutta, 2017.
The relationship between serum testosterone and luteinizing hormone (LH) levels in male patients. Source: Dutta, 2017.

A Collaborative Working Group on low testosterone in overweight and obese men. 

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