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Christian Trummer Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Stefan Pilz Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Verena Schwetz Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Barbara Obermayer-Pietsch Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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Elisabeth Lerchbaum Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria

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-based studies found that in 30–40% of infertile couples, the underlying cause is the male factor ( 13 ). One major aspect regarding male fertility is the complex interaction between pituitary gland and testis. Of note, testosterone is not only an important

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Florian Schederecker Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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Alexander Cecil Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany

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Cornelia Prehn Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany

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Jana Nano Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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Wolfgang Koenig Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
Deutsches Herzzentrum München, Technische Universität München, DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany

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Jerzy Adamski Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany
Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

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Tanja Zeller Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Germany

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Annette Peters Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany
German Centre for Cardiovascular Research (DZHK), Partner Site Munich, Munich, Germany

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Barbara Thorand Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health (GmbH), Neuherberg, Germany

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cancers ( 1 , 2 , 3 ). In women with hyperandrogenism, an increased prevalence of metabolic risk factors and risk of type 2 diabetes (T2D) and cardiovascular disease (CVD) has been observed ( 4 , 5 , 6 ). In men, high testosterone levels are associated

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Morten Ruge Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark

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Tea Skaaby Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark

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Anna-Maria Andersson Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Allan Linneberg Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Introduction Male hypogonadism is a condition in which the body produces little or no testosterone, and the risk is increased in the middle- and older-aged male population ( 1 ). The primary symptoms are reduced libido, lack of effect of

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Claus H Gravholt Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark

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Alberto Ferlin Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy

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Joerg Gromoll Centre of Reproductive Medicine and Andrology, Münster, Germany

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Anders Juul Department of Growth and Reproduction Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

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Armin Raznahan Section on Developmental Neurogenomics, National Institute of Mental Health Intramural Research Program, National Institutes of Health, Bethesda, Maryland, USA

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Sophie van Rijn Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands and TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Leiden, The Netherlands

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Alan D Rogol Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA

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Anne Skakkebæk Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark

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Nicole Tartaglia Department of Pediatrics, Developmental Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA

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Hanna Swaab Clinical Neurodevelopmental Sciences, Leiden University, Leiden, The Netherlands and TRIXY Center of Expertise, Leiden University Treatment and Expertise Centre (LUBEC), Leiden, The Netherlands

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found diminished bone mineral density (BMD) and increased risk of vertebral fractures in subjects with Klinefelter syndrome ( 18 , 19 , 20 ). Testosterone replacement therapy (TRT) increases BMD in men with Klinefelter syndrome ( 21 , 22 ), but there

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Cecilia Lundin Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

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Agota Malmborg Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Julia Slezak Clinical Chemistry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Kristina Gemzell Danielsson Department of Women’s and Children’s Health, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden

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Marie Bixo Department of Clinical Science, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden

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Hanna Bengtsdotter Department of Obstetrics and Gynaecology, Örebro University, Örebro, Sweden

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Lena Marions Department of Clinical Science and Education, Karolinska Institutet Södersjukhuset, Stockholm, Sweden

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Ingela Lindh Department of Obstetrics and Gynaecology, Sahlgrenska Academy at Gothenburg University, Sahlgrenska University Hospital, Gothenburg, Sweden

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Elvar Theodorsson Clinical Chemistry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Mats Hammar Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

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Inger Sundström-Poromaa Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

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established in COC users ( 2 , 4 ), many still believe that the COC-induced decrease in bioavailable testosterone may negatively affect sexual function ( 2 , 7 , 8 ). Hormone measurement in hair is a new method that allows non-invasive sampling of the

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Ditte Sofie Dahl Sørensen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Jesper Krogh Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Åse Krogh Rasmussen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Mikkel Andreassen Department of Endocrinology and Metabolism, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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focusing on time of day for blood sample collection, phenotype and long-acting vs short-acting glucocorticoid replacement; (iii) to assess concordance between serum levels of 17-hydroxyprogesterone, androstenedione and testosterone in relation to normal

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Clara Lundetoft Clausen Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark

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Trine Holm Johannsen Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Niels Erik Skakkebæk Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Hanne Frederiksen Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Camilla Koch Ryrsø Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – Nordsjælland, Hillerød, Denmark
Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Arnold Matovu Dungu Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – Nordsjælland, Hillerød, Denmark

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Maria Hein Hegelund Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – Nordsjælland, Hillerød, Denmark

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Daniel Faurholt-Jepsen Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Rikke Krogh-Madsen Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

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Birgitte Lindegaard Department of Pulmonary and Infectious Diseases, Copenhagen University Hospital – Nordsjælland, Hillerød, Denmark
Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Allan Linneberg Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Line Lund Kårhus Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark

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Anders Juul Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Thomas Benfield Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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in disease progression. Studies have reported association of the hypothalamic–pituitary–gonadal (HPG) axis in men hospitalized with COVID-19 with severely suppressed concentrations of testosterone and increased concentrations of estradiol with a

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M von Wolff Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland

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C T Nakas University Institute of Clinical Chemistry, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
Laboratory of Biometry, University of Thessaly, Volos, Greece

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M Tobler Division of Gynaecological Endocrinology and Reproductive Medicine, University Women’s Hospital, Bern University Hospital, University of Bern, Bern, Switzerland
Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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T M Merz Division of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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M P Hilty Intensive Care Unit, University Hospital, Zurich, Switzerland

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J D Veldhuis Endocrine Research Unit, Department of Internal Medicine, Mayo School of Graduate Medical Education, Centre for Translational Science Activities, Mayo Clinic, Rochester, New York, USA

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A R Huber Centre for Laboratory Medicine, Cantonal Hospital, Aarau, Switzerland

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J Pichler Hefti Division of Pneumology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

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−80°C thereafter. Cortisol, prolactin, thyroid-stimulating hormone (TSH), free tetraiodothyronine (fT4), free triiodothyronine (fT3), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and total testosterone (testosterone) were analysed

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M P Schuijt Department of Laboratory Medicine, Slingeland Hospital, Doetinchem, The Netherlands
Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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C G J Sweep Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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R van der Steen Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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A J Olthaar Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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N M M L Stikkelbroeck Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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H A Ross Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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A E van Herwaarden Department of Laboratory Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands

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Introduction In women, small amounts of testosterone are synthesized in the ovaries ( 1 ). Next to the gonads, testosterone is also produced and secreted from the adrenal glands in both sexes. Most testosterone circulates tightly bound to sex

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Luca Boeri Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
Department of Urology, Foundation IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

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Paolo Capogrosso Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

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Walter Cazzaniga Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Edoardo Pozzi Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Luigi Candela Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Federico Belladelli Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Davide Oreggia Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Eugenio Ventimiglia Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

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Nicolò Schifano Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Giuseppe Fallara Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Marina Pontillo Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy

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Costantino Abbate Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy

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Emanuele Montanari Department of Urology, Foundation IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy

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Francesco Montorsi Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Andrea Salonia Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
University Vita-Salute San Raffaele, Milan, Italy

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Introduction In postpuberal males the testes contribute to more than 95% of total testosterone (tT) in serum, where it equilibrates between protein-bound (98%) and free hormone (1–2%) fractions ( 1 ). Circulating testosterone is bound either

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