Assessing and treating testosterone deficiency

摘要

For a diagnosis of testosterone deficiency (TD) - or male hypo-gonadism - to be made, a male patient should present with evidence of a reduction in serum testosterone levels, as well as sexual, psychological and physical symptoms affecting their physical and mental wellbeing. A large observational cohort study of more than 1,000 patients in the United States demonstrated a clinically significant increase in prevalence of hypogonadism with increasing age. The European Male Ageing Study (EMAS), a large multinational survey of men aged 40-79 years, demonstrated a decline of free testosterone (FT) levels of 1.3% per year in males aged 40-79 years, which increased to 5.1% per year in a subpopulation analysis of males aged 70-79 years. The overall prevalence of symptomatic hypogonadism, assessed by biochemical changes and sexual symptoms, was 2.1%. Normal levels of testosterone were measured in 76.7% of the population studied in EMAS, suggesting that ageing alone was not the sole contributing factor to TD.