Red flags & when to go in person for Hypogonadism (Low Testosterone) - Evaluation

Audience: pediatric

Hypogonadism, or low testosterone, can affect children and teens, leading to delayed puberty or other health changes. This guide helps you understand when to seek in-person care and what signs need urgent attention. Telemedicine can often help with initial evaluation, answering questions, and planning tests. However, some symptoms require a physical exam or urgent care. Knowing the warning signs and preparing for your tele-visit can make the process smoother. This information is educational and does not replace a doctor’s diagnosis or treatment plan. If your child shows serious symptoms, please seek in-person medical help promptly.

Red flags — go in person / ER

• Severe testicular or groin pain or swelling — seek emergency care immediately.
• Sudden breast growth with pain, redness, or fever — go to urgent care or emergency room.
• Severe mood changes, including thoughts of self-harm — get urgent mental health support or emergency help.

What telemedicine can do

• Initial symptom discussion and medical history taking.
• Education about hypogonadism and hormonal health.
• Guidance on necessary lab tests and next steps.
• Monitoring mild symptoms and follow-up questions.

What telemedicine cannot do

• Physical examination of genitalia or pubertal development.
• Immediate treatment of severe symptoms or emergencies.
• Performing blood tests or imaging studies.
• Diagnosing complex underlying causes without in-person evaluation.

What is Hypogonadism in Children and Teens?

Hypogonadism means the body is not making enough testosterone, a hormone important for growth and puberty. In children and teens, this can cause delayed or incomplete puberty, slow growth, and other changes. It may happen due to problems in the testicles, brain, or other health issues. Early evaluation helps find the cause and plan care.

Common Signs to Watch For

Signs of low testosterone in young people may include:

If you notice these signs, a healthcare provider can help evaluate.

When to Seek In-Person Care Immediately

Some symptoms need urgent medical attention in person:

In these cases, go to an emergency room or urgent care center.

How Telemedicine Can Help

Telemedicine visits can often:

However, physical exams and some tests must be done in person.

Preparing for Your Telemedicine Visit

To get the most from your tele-visit:

This helps the healthcare provider understand your child’s health better.

After Your Telemedicine Visit

After the visit, you may need to:

Keep track of all recommendations for your child’s care.

How to prepare for your tele-visit

• List your child’s symptoms with start dates and changes over time.
• Gather any previous medical records or test results.
• Prepare a list of current medications, vitamins, or supplements.
• Write down family history related to puberty or hormonal problems.
• Find a quiet, private space with a reliable internet connection for the tele-visit.
• Prepare questions or concerns you want to discuss with the healthcare provider.

After your tele-visit

• Schedule recommended laboratory tests or imaging at a local facility.
• Arrange an in-person physical examination if advised by the provider.
• Follow prescribed treatments or lifestyle recommendations carefully.
• Monitor your child’s symptoms and report any new or worsening signs promptly.
• Plan and attend follow-up visits, either virtual or in-person, as directed.

FAQs

What causes hypogonadism in children and teens?

Hypogonadism can be caused by problems with the testicles, brain, or hormones that control puberty. Sometimes it is due to genetic conditions, injuries, infections, or other health issues. A healthcare provider can help find the cause.

Can hypogonadism be treated?

Yes, treatment depends on the cause and may include hormone therapy or addressing underlying health problems. Early treatment can help with normal growth and development.

Is telemedicine safe for evaluating low testosterone?

Telemedicine is useful for discussing symptoms, medical history, and planning tests. However, some parts of evaluation, like physical exams and blood tests, require in-person visits.

When should I worry and go to the emergency room?

Seek emergency care if your child has severe testicular pain or swelling, sudden breast growth with pain or fever, or severe mood changes including thoughts of self-harm.

How long does it take to diagnose hypogonadism?

Diagnosis can take several visits and tests. Blood tests for hormone levels and physical exams are important. Your healthcare provider will guide you through the process.

Sources

1. Hypogonadism — MedlinePlus, U.S. National Library of Medicine.
2. Delayed Puberty in Boys — American Academy of Pediatrics.
3. Low Testosterone (Male Hypogonadism) — Mayo Clinic.
4. Hypogonadism in Children and Adolescents — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. Always seek direct evaluation by a healthcare professional for diagnosis and treatment decisions, especially if your child has severe or worsening symptoms.