Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Daryl Sieg


Male obesity; Testosterone levels; MOSH


The link between obesity and testosterone deficiency has often been a topic of research. Male obesity-related secondary hypogonadism (MOSH) is often underdiagnosed in the young male population. The current standard of care for hypogonadism in the older male population typically includes testosterone replacement therapy (TRT). The purpose of this study is to highlight available treatment options for MOSH in the younger population and the various effects on fertility. The method utilized was a systematic review of the current literature that targeted obese males below the age of 65 treated for secondary hypogonadism. The review excluded articles published longer than ten years ago or if the studies chosen solely included animals. To date, there has not been a consensus statement made for specifically treating the young male with a diagnosis of MOSH who desires the preservation of fertility. This review highlights some of the current recommendations, including lifestyle changes, and compares the use of TRT and selective estrogen receptor modulators (SERMs) and the effects on reproductive health. Promisingly, SERMs were found to be more protective of sperm production than traditional testosterone replacement. Many providers and patients need further education on this topic. Future research is needed to include randomized controlled trials (RCTs) that directly compare SERMs with TRT to provide definitive data supporting the use of this alternative treatment.