CoChat
Sign Up
Cited by 722Hormonal and reproductive studiesAdrenal Hormones and DisordersSperm and Testicular Function

Prevalence of Symptomatic Androgen Deficiency in Men

Araujo, Andre B., Esche, Gretchen R., Kupelian, Varant, O’Donnell, Amy B., Travison, Thomas G., Williams, Rachel E., Clark, Richard V., McKinlay, John B.·2007·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2007-1245
Open this paper in CoChat — free account

Abstract

Context: Despite recognition that androgen deficiency in men should be defined according to biochemical and clinical criteria, most prevalence estimates are based on low testosterone levels alone. Objective: The objective of this study was to examine the association between symptoms of androgen deficiency and low total and calculated free testosterone levels and estimate the prevalence of symptomatic androgen deficiency in men. Design: This study was a population-based, observational survey. Participants: A total of 1475 Black, Hispanic, and white men, between the ages of 30–79 yr, with complete data on testosterone, SHBG, and symptoms of androgen deficiency, and who are not taking medications that impact sex steroid levels were randomly selected from the Boston Area Community Health Survey. Outcome: Outcomes were measured as symptomatic androgen deficiency, defined as low total (<300 ng/dl) and free (<5 ng/dl) testosterone plus presence of low libido, erectile dysfunction, osteoporosis or fracture, or two or more of following symptoms: sleep disturbance, depressed mood, lethargy, or diminished physical performance. Results: Mean age of the sample was 47.3 ± 12.5 yr. Approximately 24% of subjects had total testosterone less than 300 ng/dl, and 11% of subjects had free testosterone less than 5 ng/dl. Prevalence of symptoms were as follows: low libido (12%), erectile dysfunction (16%), osteoporosis/fracture (1%), and two or more of the nonspecific symptoms (20%). Low testosterone levels were associated with symptoms, but many men with low testosterone levels were asymptomatic (e.g. in men 50+ yr, 47.6%). Crude prevalence of symptomatic androgen deficiency was 5.6% (95% confidence interval: 3.6%, 8.6%), and was not significantly related to race and ethnic group. Prevalence was low in men less than 70 yr (3.1–7.0%) and increased markedly with age to 18.4% among 70 yr olds. Projection of these estimates to the year 2025 suggests that there will be as many as 6.5 million American men ages 30–79 yr with symptomatic androgen deficiency, an increase of 38% from 2000 population estimates. Conclusions: Prevalence of symptomatic androgen deficiency in men 30 and 79 yr of age is 5.6% and increases substantially with age. The aging of the U.S. male population will cause a large increase in the burden of symptomatic androgen deficiency. Future work should address the clinical significance of low testosterone levels in asymptomatic men.

Integrity signals

Registry

Crossref · 10.1210/jc.2007-1245

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The prevalence of symptomatic hypogonadism is poorly defined, with estimates of 2.1-17% in population-based surveys of men aged 30-87 years depending on the criterion used.

    “The prevalence of symptomatic hypogonadism remains poorly defined, with estimates ranging from 2.1–17% in population-based surveys of men aged 30–87 years depending upon criterion utilized.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [2]

  • Many studies are hindered by heterogeneity in the definition of low free testosterone (50-65 pg/ml), and increasing the threshold for low free testosterone raises sensitivity and reduces specificity compared with total testosterone.

    “However, many of these studies are hindered by heterogeneity in the definition for low fT (50–65 pg/ml [173.4–225.4 pmol/L]), with increases in the threshold for low fT resulting in higher sensitivity and reduced specificity when compared to TT.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [2]

  • Other studies have shown increased associations between free testosterone and comorbid conditions including depression and hypogonadal symptoms.

    “Other studies have also demonstrated increased associations between fT and other comorbid conditions, including depression and hypogonadal symptoms.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [2]

  • Free testosterone is a better indicator in young males than in elderly men, suggesting that the age-associated increase in SHBG may further reduce free testosterone specificity.

    “Free T is also better indicator in young males as compared to elderly men, suggesting that the age-associated increase in SHBG may further reduce the specificity of fT.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [2]

  • In a population-based observational survey of 1,475 men aged 30-79 years, increasing the lower free testosterone threshold (50-60 or 60-70 pg/mL) reduced specificity for symptoms such as low libido (28.1%, 23.9%, and 19.8% for 50, 60, and 70 pg/mL, respectively).

    “The authors noted that increasing the lower fT threshold (50–60, or 60–70pg/ml [173.4–208 and 208–242.7 pmol/L]) resulted in reduced specificity for symptoms such as low libido (28.1%, 23.9%, and 19.8% for 50, 60, and 70pg/ml [242.7 pmol/L], respectively).”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [2]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Araujo, A. B., Esche, G. R., Kupelian, V., O’Donnell, A. B., Travison, T. G., Williams, R. E., Clark, R. V., & McKinlay, J. B.
Affiliations
  • New England Research Institutes, Inc. (A.B.A., G.R.E., V.K., A.B.O., T.G.T., J.B.M.), Watertown, Massachusetts 02472
  • New England Research Institutes (US)
  • GlaxoSmithKline (United States) (US)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2007-11-01
Volume
92
Issue
11
Pages
4241-4247
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2007-1245
OpenAlex
W2135798327
Cited by
720
References
45
Citations by year
2026: 16 · 2025: 32 · 2024: 23 · 2023: 31 · 2022: 46 · 2021: 30 · 2020: 40 · 2019: 29 · 2018: 28 · 2017: 46 · 2016: 58 · 2015: 49 · 2014: 57 · 2013: 48 · 2012: 45
FWCI
25.58
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Aging (R01AG020727)
  • National Institute of Diabetes and Digestive and Kidney Diseases (DK56842)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
Keywords
androgen deficiency, free testosterone, prevalence, men, low libido, erectile dysfunction, osteoporosis, sex hormone-binding globulin, age-related decline, racial and ethnic differences, sex steroid levels, sleep disorders, depressive mood, physical performance, men's health, older men
MeSH terms
Adult, Aged, Androgens, Boston, Data Interpretation, Statistical, Endocrine System Diseases, Ethnicity, Humans, Male, Middle Aged, Gonadal Steroid Hormones, Testosterone, Cluster Analysis

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 ›

Are you an author, or do you see a problem with this page? Request a review