Current state of knowledge on low testosterone in middle-aged and older men

April 2012

This article reviewed what is known about the consequences of low testosterone (also known as hypogonadism) in middle-aged and older men, with practical information on the benefits and risks of testosterone replacement. The authors examined evidence from a wide range of studies about low testosterone and its treatment to prepare their review.

Key findings

  • Low testosterone is a common and under-diagnosed condition linked with aging and with common medical conditions such as obesity, metabolic syndrome, type 2 diabetes mellitus and high blood pressure
  • Low testosterone levels increase the risk of death from cardiovascular disease and other causes in men 40 years or older
  • There is good evidence that testosterone therapy helps to reduce body fat and waist circumference, which are key elements of treating individuals with metabolic syndrome or diabetes
  • Testosterone therapy also helps improve glucose control and blood lipid profiles, by reducing “bad” triglycerides and increasing “good” high-density lipoprotein cholesterol in men with low testosterone who also have metabolic syndrome
  • The benefits of testosterone therapy in improving sexual desire and erectile function are well known, but there is increasing evidence that testosterone therapy has other benefits and can help to improve the quality of life and help with overall good health in men with low testosterone
  • Doctors diagnose low testosterone by checking levels of testosterone in the body, along with careful consideration of other signs or symptoms of low testosterone, such as decreased libido (sexual desire), erectile dysfunction (impotence) and chronic fatigue
  • If a decision is made to start testosterone therapy to restore testosterone levels to normal, a range of testosterone formulations are available, including short-acting injections, topical gels or patches that are applied to the skin, testosterone pellets that are inserted under the skin, and long-acting testosterone injections
  • Current treatments for low testosterone have a good safety record, and any unwanted effects are generally reversible if treatment is stopped, but physicians treating patients with low testosterone have a responsibility to explain any possible side effects, along with the benefits of treatment.

Source: Traish AM, Miner MM, Morgentaler A, et al. Testosterone deficiency. Am J Med 2011;124(7):578-587.

Background information

Low testosterone is a common and under-recognized condition associated with aging and with common medical conditions. This article looked at a host of studies about low testosterone and the use of testosterone therapy and presented practical and up-to-date information on diagnosis and treatment. Treating low testosterone can help to improve general male health beyond the commonly-known benefits on sexual health.