Features of testosterone deficiency can be very apparent, which is why the first steps in diagnosing male hypogonadism involve adequate history taking and physical exam. The features indicative of male hypogonadism can be divided into pre and post-pubertal. Pre-pubertal features include small testes (less than 20 mL in volume), small phallus, decreased secondary sex characteristics (eg, facial or axillary hair), gynecomastia, difficulty gaining muscle mass, eunuchoid proportions, low sperm count, and low energy/libido. Post-pubertal features include those previously mentioned (except phallus size and eunuchoid proportions), osteoporosis, and hot flashes with severe hypogonadism.
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This map shows cities, towns, villages, highways, main roads, secondary roads, railroads, seaports, airports, mountains, landforms, rivers and lakes in Russia.
Largest cities: Moscow , Saint Petersburg , Novosibirsk, Yekaterinburg, Nizhny Novgorod, Kazan, Chelyabinsk, Omsk, Samara, Ufa, Rostov-na-Donu, Krasnoyarsk, Perm, Voronezh, Volgograd, Krasnodar, Saratov, Tolyatti, Izhevsk, Tyumen, Ulyanovsk, Barnaul, Irkutsk, Khabarovsk, Makhachkala, Yaroslavl, Vladivostok, Orenburg, Tomsk, Kemerovo, Novokuznetsk.
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In recent years, Moscow has undergone extensive urban development, including the renovation of public spaces, parks, and historical buildings. The city hosted several matches during the 2018 FIFA World Cup, including the opening game and final, demonstrating its capability to manage major international events.
These can be caused by low testosterone levels due to problems in the testicles and/or hypothalamus and pituitary, or because testosterone does not act properly in the body’s cells.
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