Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: The healthy man study

Sartorius, Gideon; Spasevska, Sasa; Idan, Amanda; Turner, Leo; Forbes, Elise; Zamojska, Anna; Allan, Carolyn A.; Ly, Lam P.; Conway, Ann J.; McLachlan, Robert I.; Handelsman, David J.

doi:10.1111/j.1365-2265.2012.04432.x

Cited by 209Hormonal and reproductive studiesSperm and Testicular FunctionAdrenal Hormones and Disorders

Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: The healthy man study

Sartorius, Gideon, Spasevska, Sasa, Idan, Amanda, Turner, Leo, Forbes, Elise, Zamojska, Anna, Allan, Carolyn A., Ly, Lam P. +3 more·2012·Clinical Endocrinology

DOI 10.1111/j.1365-2265.2012.04432.x

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Abstract

Summary: Objective: To determine serum concentrations, intra‐individual variability and impact of age‐related co‐morbidities on serum testosterone (T), dihydrotestosterone (DHT), estradiol (E 2) and estrone (E 1) in older men. Design: Observational, repeated measures study. Participants: Men (n = 325) with 40 years and older self‐reporting very good or excellent health. Measurements: Standardized history, physical examination and collection of nine blood samples at fixed time intervals were measured over 3 months (three at 20 min intervals on days 1 (fasting) and 2 (non‐fasting), one at days 7, 30 and 90). Serum T, DHT, E 2 and E 1 (n = 2900, > 99% of scheduled samples) measured by liquid chromatography‐tandem mass spectrometry (LC‐MS) were analysed by linear mixed model analysis with fasting, age and obesity as covariables. Results: Mean serum T did not vary with age (P = 0·76) but obesity (−0·35 n m per body mass index (BMI) unit, P < 0·0001) and ex‐smoker status (−1·6 n m, P < 0·001) had significant effects. Serum DHT was increased with age (+0·011 n m per year, P = 0·001) but decreased with obesity (−0·05 n m per BMI unit, P < 0·0001). Serum E 2 did not vary with age (P = 0·31) or obesity (P = 0·12). Overnight fasting increased (by 9–16%, all P < 0·001) and reduced variability in morning serum T, DHT, E 2 and E 1. Non‐fasting serum T and DHT were stable over time (day, week, month or 3 months; P > 0·28). Conclusions: Serum T, DHT and E 2 displayed no decrease associated with age among men over 40 years of age who self‐report very good or excellent health although obesity and ex‐smoking status were associated with decreased serum androgens (T and DHT) but not E 2. These findings support the interpretation that the age‐related decline in blood T accompanying non‐specific symptoms in older men may be due to accumulating age‐related co‐morbidities rather than a symptomatic androgen deficiency state.

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Healthy ageing by itself is uncommonly associated with marked reductions in testosterone levels.
“Conversely, there is increasing evidence that healthy ageing by itself is uncommonly associated with marked reductions in testosterone levels.23”
From Lowered testosterone in male obesity: Mechanisms, morbidity and management (2014) · cites this paper as [23]
Early studies comparing young men aged 25-27 with elderly men aged 71 found peak testosterone concentrations from 3-8 AM, extended to 2 PM in elderly men, and trough levels from early afternoon to late evening.
“Early studies comparing young (mean age 25–27 years) versus elderly males (mean age 71 years) demonstrated peak T concentrations in the 3–8 AM time period (extended to 2 PM in elderly males), with trough levels noted in the early afternoon to late evening.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [43]
Testosterone levels exhibit time-, sleep-, and age-dependent circadian variations.
“T levels exhibit time, sleep, and age-dependent circadian variations.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [43]
Despite similar daily patterns, elderly males had significant blunting of peak versus trough testosterone levels, with differences of 61-205 ng/dl compared with 141-354 ng/dl in younger men.
“Despite similar patterns of variation throughout the day, elderly males experienced significant blunting of peak versus trough levels, with differences in high and low values of 61–205 ng/dl (2.1–7.1 nmol/L) compared to 141–354 ng/dl (4.9–12.3 nmol/L) in younger men.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [43]

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Authors: Sartorius, G., Spasevska, S., Idan, A., Turner, L., Forbes, E., Zamojska, A., Allan, C. A., Ly, L. P., Conway, A. J., McLachlan, R. I., & Handelsman, D. J.
Affiliations: The University of Sydney (AU)
Concord Hospital (US)
Prince Henrys Institute Clayton
Corresponding author: Handelsman, David J.
ORCID: Sartorius, Gideon
Turner, Leo
Allan, Carolyn A.
Conway, Ann J.
McLachlan, Robert I.
Handelsman, David J.
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 2012-10-05
Volume: 77
Issue: 5
Pages: 755-763
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1111/j.1365-2265.2012.04432.x
OpenAlex: W1984060669
Cited by: 209
References: 41
Citations by year: 2026: 6 · 2025: 4 · 2024: 5 · 2023: 24 · 2022: 9 · 2021: 10 · 2020: 14 · 2019: 14 · 2018: 12 · 2017: 16 · 2016: 26 · 2015: 23 · 2014: 23 · 2013: 18 · 2012: 4
FWCI: 17.45
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: Bupa Foundation
Bupa Health Foundation
Centers for Disease Control and Prevention
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: serum testosterone, dihydrotestosterone, estradiol, estrone, older men, aging, obesity, smoking, fasting effects, diurnal variation, androgen levels, healthy aging
MeSH terms: Aged, Estradiol, Humans, Male, Middle Aged, Dihydrotestosterone, Testosterone

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Serum testosterone, dihydrotestosterone and estradiol concentrations in older men self-reporting very good health: The healthy man study

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