When evaluating impotence, testosterone replacement is considered if what condition is present?

• A. Low testosterone
• B. Normal testosterone
• C. High prolactin
• D. Low cortisol

Answer: (A)

Testosterone replacement is considered when there is biochemical and clinical hypogonadism—low testosterone levels with symptoms such as reduced libido or erectile difficulties. In evaluating impotence, a low morning testosterone confirmed on repeat testing indicates that restoring testosterone may improve sexual function and energy, assuming there are no contraindications. Normal testosterone does not warrant replacement, and elevated prolactin points to a different underlying problem (prolactin-secreting pituitary disorder) that should be addressed rather than treated with testosterone. Low cortisol indicates adrenal insufficiency, which requires glucocorticoid replacement rather than testosterone.