Epidemiology

Several epidemiological studies confirm age-related decreases in serum total testosterone concentrations.[9] In one US study, the prevalence of symptomatic androgen deficiency was 5.6% in men aged between 30 and 79 years.[10] Prevalence was low (3% to 7%) in men aged under 70 years and increased markedly to 18.4% among men 70 years and older.[10]

The European Male Ageing Study (EMAS) reported late-onset hypogonadism (defined as decreased sexual interest, decreased morning erections, and erectile dysfunction, in combination with testosterone deficiency) prevalence of 2.1% in men aged 40 to 79 years.[5][6]​​[11]​​ The age-related accumulation of non-gonadal co-morbidities causing gonadotrophin suppression (e.g., obesity) was a greater risk factor for falling testosterone levels than chronological age.[5][12] Men with late-onset hypogonadism were at increased risk for diabetes and cardiovascular disease compared with eugonadal men.[13] Broadly similar findings were reported in the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China) study.[14]

Estimation of hypogonadism prevalence based on large population database surveys of testosterone replacement therapy prescriptions is not recommended; studies have found that testosterone therapy is often initiated in the absence of a diagnosis of hypogonadism as specified by guideline recommendations.[7]

Use of this content is subject to our disclaimer