Secondary hypogonadism was not frequent in some case series of patients evaluated for erectile dysfunction, unless associated with hyperprolactinemia. Slag et al found 9% prevalence of secondary hypogonadism in 188 patients with
impotency. In a study by Rhoden et al on pituitary imaging in male hypogonadism, MRI pituitary was normal in 74.5% of patients, partial empty sella in 17.6% and pituitary microadenomas were found in 7.8% of patients, and like our study, 89% of patients younger than 40 years had normal MRI.