Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men

Top Cited Papers
Open Access
Publisher Website
Google Scholar
Abstract
IT is now well accepted that serum testosterone (T) levels decline progressively with aging in men (1)(2)(3)(4)(5). This decline is associated with alterations in body composition; diminished energy, muscle strength, and physical function; reduced sexual function; depressed mood; and decreased cognitive function. Similar changes occur in young men with androgen deficiency and are improved with T replacement therapy. However, the physiological and clinical significance of the aging-associated decline in serum T levels in men is unclear, particularly because T levels may remain within the normal range for young men. From a practical clinical standpoint, it is most appropriate to define “andropause” as an age-related decline in serum T levels in older men to below the normal range in young men that is associated with a clinical syndrome (i.e., symptoms and signs) consistent with androgen deficiency. The decline in T levels is a consequence both of aging per se and age-associated comorbid illnesses and medications that are used to treat them (6)(7)(8)(9)(10)(11)(12)(13). However, regardless of the etiology, androgen deficiency may contribute, at least in part, to age-related decrements in physiological function and may be associated with a clinical syndrome.