Figure 2: The vicious cycle of hypogonadism, obesity, and dyslipidemia. Low testosterone can cause obesity and fat accumulation, which results in dyslipidemia and further deposition of visceral fat. Obesity can also decrease testosterone levels through conversion of aromatase to estradiol in the adipose tissue and through the release of inflammatory cytokines that can inhibit the hpothalamo-pituitary-gonadal axis at multiple levels.