The association of time of day and serum testosterone concentration in a large screening population
Abstract
Authors from the USA reviewed semen samples for their National Prostate Cancer Awareness screening programme. They evaluated semen testosterone levels at various times during the day, depending on when the person attended for screening. In this study, they found that testosterone levels in older men remain stable throughout the morning and early afternoon, and declined only moderately after that. Further case control studies have been suggested to confirm this finding. In a study from the UK, changes to PSA screening programmes, such as lowering the threshold or incorporating reflex PSA tests, have been looked at, particularly their impact on programme performance characteristics. The authors found that such changes will increase the number of biopsies and the number of cancers detected, but the authors question whether this will improve treatment outcomes. OBJECTIVE: To assess testosterone patterns during clinical hours in a large population of men participating in a national screening programme for prostate cancer, as the effect of time of day on serum testosterone concentration is unclear and largely reported in small studies. SUBJECTS AND METHODS: Testosterone levels were measured in 3006 men attending the national Prostate Cancer Awareness Week screening programme. Blood samples were obtained between 06.00 and 18.00 hours, whenever men presented for screening. All men completed questionnaires on age, comorbidities, height and weight. Testosterone levels were compared based on four periods, i.e. T1, 06.00–10.00 (632 men), T2, 10.00–12.00 (812), T3, 12.00–14.00 (388), and T4, 14.00–18.00 hours (1174). RESULTS: The mean ( sd , range) age of the men was 60.3 (9.9, 40–94) years and the mean ( sd ) testosterone level was 415.2 (190.9) ng/dL. There was no change in mean ( sd ) testosterone levels over T1, T2 and T3, at 444.9 (206.2), 433.5 (195.8) and 434.4 (181.2) ng/dL, respectively, but levels at T4, at 380.4 (176.4) ng/dL, were lower by ≈ 13% ( P < 0.05). Advancing age, diabetes and obesity were associated with lower testosterone levels. The percentage of men with biochemical hypogonadism (<300 ng/dL) did not change across all four periods. CONCLUSIONS: Testosterone levels in older men are stable throughout the morning and early afternoon, declining only modestly thereafter. Further case‐controlled studies are needed to confirm these findings.
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Compared with aerobic activity, resistance exercise likely produces greater testosterone improvements, with untrained men having larger increases than those routinely performing resistance exercise.
“Compared to aerobic activity, resistance exercise likely results in greater improvements in T, with untrained men experiencing larger increases compared to those routinely performing resistance exercises.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [73]
Exercise is independently associated with increasing testosterone levels.
“In addition to weight loss, exercise is independently associated with increasing T levels.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [73]
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- Authors
- Crawford, E. D., Barqawi, A. B., O’Donnell, C., & Morgentaler, A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Barqawi, Al Baha
- Venue
- BJU International
- Publisher
- Wiley
- Published
- 2007-07-31
- Volume
- 100
- Issue
- 3
- Pages
- 509-513
- ISSN
- 1464-4096 (ISSN-L)
- 1464-410X
- OpenAlex
- W2001427830
- Cited by
- 68
- References
- 24
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 6 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 1
- FWCI
- 3.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Urology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- serum testosterone, time of day, circadian variation, prostate cancer screening, prostate-specific antigen, biopsy rate, prostate cancer detection, older men, diabetes mellitus, obesity, age
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Circadian Rhythm, Cross-Sectional Studies, Humans, Hypogonadism, Male, Mass Screening, Middle Aged, Prostatic Neoplasms, Testosterone, Time Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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