Testosterone for the aging male; current evidence and recommended practice
Open accessAbstract
An international consensus document was recently published and provides guidance on the diagnosis, treatment and monitoring of late-onset hypogonadism (LOH) in men. The diagnosis of LOH requires biochemical and clinical components. Controversy in defining the clinical syndrome continues due to the high prevalence of hypogonadal symptoms in the aging male population and the non-specific nature of these symptoms. Further controversy surrounds setting a lower limit of normal testosterone, the limitations of the commonly available total testosterone result in assessing some patients and the unavailability of reliable measures of bioavailable or free testosterone for general clinical use. As with any clinical intervention testosterone treatment should be judged on a balance of risk versus benefit. The traditional benefits of testosterone on sexual function, mood, strength and quality of life remain the primary goals of treatment but possible beneficial effects on other parameters such as bone density, obesity, insulin resistance and angina are emerging and will be reviewed. Potential concerns regarding the effects of testosterone on prostate disease, aggression and polycythaemia will also be addressed. The options available for treatment have increased in recent years with the availability of a number of testosterone preparations which can reliably produce physiological serum concentrations.
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Serum testosterone levels decline with age, commencing in men in their mid-30s and decreasing at an average annual rate of 1.6%.
“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 [42]
The “Changes in testosterone levels with aging” section reports that total testosterone declines by an average of 1.6% per year. It does not say that the decline begins in men in their mid-30s; that onset age is unsupported by this source. The citing authors’ proposed explanation of their phenomenon is their own speculation, not a finding attributed to this paper. (LLM, conf=0.88)
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- Authors
- Jones, H.
- Affiliations
- Barnsley Hospital NHS Foundation Trust (GB)
- Corresponding author
- Jones, Hugh
- Venue
- Clinical Interventions in Aging
- Publisher
- Informa UK Limited
- Published
- 2008-03
- Volume
- Volume 3
- Issue
- 1
- Pages
- 25-44
- ISSN
- 1176-9092 (ISSN-L)
- 1178-1998
- PMC
- PMC2544367
- OpenAlex
- W2171390564
- Cited by
- 204
- References
- 39
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 22 · 2023: 13 · 2022: 12 · 2021: 10 · 2020: 16 · 2019: 13 · 2018: 10 · 2017: 13 · 2016: 8 · 2015: 4 · 2014: 9 · 2013: 7 · 2012: 5
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Clinical Interventions in Aging (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- andropause, testosterone replacement therapy, older men, hypogonadism diagnosis, risk-benefit assessment, sexual function, bone mineral density, prostate diseases, polycythemia, aggression, testosterone formulations, quality of life
- MeSH terms
- Aged, Aging, Androgens, Blood Glucose, Body Composition, Clinical Trials as Topic, Diabetes Mellitus, Type 2, Humans, Hypogonadism, Erectile Dysfunction, Male, Obesity, Osteoporosis, Prostatic Neoplasms, Testosterone, Bone Density, Age of Onset
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