Low Testosterone in Older Men Less Common Than Thought

In describing a set of concrete symptoms for "male menopause" for the first time, British researchers have also determined that only about 2% of men aged 40 to 80 suffer from the condition, far less than previously thought.

Male menopause, also called "andropause" or late-onset hypogonadism, supposedly results from declines in testosterone production that occur later in life, but there has been some debate on how real the phenomenon is, the study authors noted.

"Some aging men indeed suffer from [male menopause]. It is a genuine syndrome, but much less common than previously assumed," concludes Dr. Ilpo Huhtaniemi, senior author of a study published online in The New England Journal of Medicine.

"This is important because it demonstrates that genuine symptomatic androgen [male hormones] deficiencies is less common than believed, and that only the right patients [should] get androgen treatment," adds Huhtaniemi, a professor of reproductive endocrinology in the department of surgery and cancer at Imperial College London.

For this study, the research team, from Imperial College London and the University of Manchester, measured testosterone levels in 3,369 men aged 40 to 79 and then correlated these levels with different symptoms.

Of 32 possible symptoms, only nine were linked with decreased testosterone levels. Three were physical—not being able to engage in strenuous physical activity, not being able to walk more than 1 km and not being able to bend over or kneel—and three were psychological—low energy, sadness, and fatigue. But these six symptoms were only peripherally linked to low testosterone levels.

Three sexual symptoms—less frequent morning erections, lower sex drive, and erectile dysfunction—were more robustly related to testosterone levels.

Men need to have all three sexual symptoms plus measurably lower levels of testosterone to qualify for the diagnosis of late-onset hypogonadism, the authors stated.

But even with this new diagnostic criteria, the challenge of treating men with sexual and other symptoms of male menopause is still far from straightforward.

Source: Brigham and Women's Hospital