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Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men: Longitudinal Results from the Massachusetts Male Aging Study
Abstract
We used longitudinal data from the Massachusetts Male Aging Study, a large population-based random-sample cohort of men aged 40-70 yr at baseline, to establish normative age trends for serum level of T and related hormones in middle-aged men and to test whether general health status affected the age trends. Of 1,709 men enrolled in 1987-1989, 1,156 were followed up 7-10 yr afterward. By repeated-measures statistical analysis, we estimated simultaneously the cross-sectional age trend of each hormone between subjects within the baseline data, the cross-sectional trend between subjects within the follow-up data, and the longitudinal trend within subjects between baseline and follow-up. Total T declined cross-sectionally at 0.8%/yr of age within the follow-up data, whereas both free and albumin-bound T declined at about 2%/yr, all significantly more steeply than within the baseline data. Sex hormone-binding globulin increased cross-sectionally at 1.6%/yr in the follow-up data, similarly to baseline. The longitudinal decline within subjects between baseline and follow-up was considerably steeper than the cross-sectional trend within measurement times for total T (1.6%/yr) and bioavailable T (2-3%/yr). Dehydroepiandrosterone, dehydroepiandrosterone sulfate, cortisol, and estrone showed significant longitudinal declines, whereas dihydrotestosterone, pituitary gonadotropins, and PRL rose longitudinally. Apparent good health, defined as absence of chronic illness, prescription medication, obesity, or excessive drinking, added 10-15% to the level of several androgens and attenuated the cross-sectional trends in T and LH but did not otherwise affect longitudinal or cross-sectional trends. The paradoxical finding that longitudinal age trends were steeper than cross-sectional trends suggests that incident poor health may accelerate the age-related decline in androgen levels.
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“This is because declines in testosterone per year of age is 2–threefold greater with longitudinal compared with cross-sectional analysis of the same cohort [35, 36].”
From Sleep, testosterone and cortisol balance, and ageing men (2022) · cites this paper as [35]
In the citing paper
“About 2% of circulating T is free (unbound), 44% is bound to sex hormone-binding globulin (SHBG), and 54% is bound to albumin and other proteins (98).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [98]
In the citing paper
“We speculate that this phenomenon may be attributed to the gradual decline in serum testosterone levels with age, commencing in men in their mid-30s and decreasing at an average annual rate of 1.6%38–43.”
From Association between serum cotinine and total testosterone in adult males based on NHANES 2011–2016 (2024) · cites this paper as [39]
In the citing paper
“Age, 11,14-17 body mass index (BMI), 12 fasting blood glucose, 1,35 triglycerides, 36 alcohol consumption 13,14 and estradiol levels, 13 which have all been reported to be associated with alteration in hormone levels, were chosen as potential confounding factors in this study.”
From Cigarette smoking has a positive and independent effect on testosterone levels (2013) · cites this paper as [16]
In the citing paper
“Probable and possible associations of several factors, including age, cigarette smoking, body mass index (BMI), alcohol consumption and physical activity with hormone levels have been reported. 11-17”
From Cigarette smoking has a positive and independent effect on testosterone levels (2013) · cites this paper as [16]
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Bhasin, S., Cunningham, G. R., Hayes, F. J., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Montori, V. M. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2354 · Cited by 1,954
Identification of late-onset hypogonadism in middle-aged and elderly men
Wu, F. C. W., Tajar, A., Beynon, J. M., Pye, S. R., Silman, A. J., Finn, J. D., O'Neill, T. W., Bartfai, G., Casanueva, F. F., Forti, G., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0911101 · Cited by 1,544
The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications
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Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences
Mielke, M., Vemuri, P., & Rocca, W. (2014) · Clinical Epidemiology · doi:10.2147/clep.s37929 · Cited by 1,021
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Metadata
- Authors
- Feldman, H. A., Longcope, C., Derby, C. A., Johannes, C. B., Araujo, A. B., Coviello, A. D., Bremner, W. J., & McKinlay, J. B.
- Affiliations
- New England Research Institutes (US)
- University of Massachusetts Chan Medical School (US)
- University of Washington (US)
- Corresponding author
- McKinlay, John B.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2002-02
- Volume
- 87
- Issue
- 2
- Pages
- 589-598
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2161057551
- Semantic Scholar
- c34a4f1c4913ce7de26805a673886cab9c442eb2
- Cited by
- 1,861
- References
- 55
- Citations by year
- 2026: 34 · 2025: 68 · 2024: 80 · 2023: 69 · 2022: 90 · 2021: 91 · 2020: 107 · 2019: 82 · 2018: 76 · 2017: 77 · 2016: 113 · 2015: 90 · 2014: 110 · 2013: 90 · 2012: 94
- FWCI
- 27.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- ResearchWorks at the University of Washington (University of Washington) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- serum testosterone, age-related decline, middle-aged men, sex hormone-binding globulin, free testosterone, bioavailable testosterone, dehydroepiandrosterone, dehydroepiandrosterone sulfate, cortisol, estrone, dihydrotestosterone, gonadotropins, prolactin, health status, androgens, Massachusetts Male Aging Study
- MeSH terms
- Adult, Aged, Aging, Cross-Sectional Studies, Hormones, Humans, Longitudinal Studies, Male, Middle Aged, Random Allocation, Reference Values, Testosterone, Cohort Studies
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- CoChat. (2026). Citation check: Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men: Longitudinal Results from the Massachusetts Male Aging Study. https://app.cochat.ai/papers/10.1210/jcem.87.2.8201
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- Feldman, H. A., Longcope, C., Derby, C. A., Johannes, C. B., Araujo, A. B., Coviello, A. D., Bremner, W. J., & McKinlay, J. B. (2002). Age Trends in the Level of Serum Testosterone and Other Hormones in Middle-Aged Men: Longitudinal Results from the Massachusetts Male Aging Study. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/jcem.87.2.8201
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
