Expert Opinion on the Diagnosis and Management of Male Hypogonadism in India
Table 1
Expert opinion on culture specific factors related to male hypogonadism.
(1) Most men are generally shy about discussing their sexual problems and tend to schedule multiple appointments for medical consultation
(2) Personality differences also impact men’s willingness to report sexual dysfunction; for example, some men are vocal, while others tend to consider sexual dysfunction normal and not requiring medical consultation. Rushing in outpatient departments also deters men from being vocal about sexual dysfunction
(3) Hypogonadism, especially in older adults, goes unreported because most patients consider sexual dysfunction normal and part of the aging process. (i) After the age of 50 years, most Indian men do not complain of the problems related to hypogonadism, that is, sexual dysfunction; therefore, the incidence of MH in India is not an accurate indicator of the true prevalence
(4) Although there is no noticeable geographic skewness, a panelist mentioned that educated patients from north India are more comfortable discussing their sexual health than patients from the rest of the country
(5) Most Indian physicians are not trained in the etiquette of taking a sexual history or in the subject of MH. This leads to suboptimal clinician suspicion and screening
(6) A window of opportunity exists in mid-life: men who visit doctors with symptoms of prostatism must be screened for MH
