INTERPRETATION We found weak correlation between signs , symptoms and testosterone levels , uncertainty about what threshold testosterone levels should be considered low for aging men and wide variation in estimated prevalence of the condition .
It is therefore difficult to extrapolate the method of diagnosing pathologic hypogonadism in younger men to clinical decisions regarding age-related testosterone decline in aging men
BACKGROUND Physicians diagnose and treat suspected hypogonadism in older men by extrapolating from the defined clinical entity of hypogonadism found in younger men .
We conducted a systematic review to estimate the accuracy of clinical symptoms and signs for predicting low testosterone among aging men .
Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study.
We used longitudinal data from the Massachusetts Male Aging Study , a large population -based r and om- 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 ) . Dehydroepi and rosterone , dehydroepi and rosterone 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 and rogens 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 and rogen levels
INTERPRETATION We found weak correlation between signs , symptoms and testosterone levels , uncertainty about what threshold testosterone levels should be considered low for aging men and wide variation in estimated prevalence of the condition .
It is therefore difficult to extrapolate the method of diagnosing pathologic hypogonadism in younger men to clinical decisions regarding age-related testosterone decline in aging men
BACKGROUND Physicians diagnose and treat suspected hypogonadism in older men by extrapolating from the defined clinical entity of hypogonadism found in younger men .
We conducted a systematic review to estimate the accuracy of clinical symptoms and signs for predicting low testosterone among aging men .