Reproductive endocrine functions were studied in men with primary hypothyroidism during the hypothyroid phase and after achieving euthyroid status with thyroxine substitution therapy. Hypergonadotropism [luteinising hormone (LH), 18.7 ± 7.3 IU/1; follicle-stimulating hormone (FSH), 6.3 ± 2.0 IU/1], low serum testosterone (6.1 ± 2.8 nmol/l), low serum sex-hormone-binding globulin (SHBG; 13.2 ± 2.0 nmol/l) and subnormal testosterone response to human chorionic gonadotropin hCG; (30% increase in serum testosterone following hCG) observed during the hypothyroid phase were restored to normal (LH, 7.2 ± 2.0 IU/1; FSH, 2.7 ± 0.9 IU/1; testosterone, 12.9 ± 2.7 nmol/l; SHBG, 26.5 ± 8.4 nmol/l, and 2-fold increase in serum testosterone following hCG) with thyroxine substitution therapy. Some improvement in sperm count and motility was also observed.