Evidence-based criteria for diagnosing low testosterone in aging men defined
This study, published in the New England Journal of Medicine, identified the most important symptoms linked to late-onset hypogonadism (low testosterone levels in aging men) in a large group of men representative of the general population. When testosterone levels were also taken into consideration, having these three symptoms and low testosterone levels was a specific diagnosis of late-onset hypogonadism.
A large number of signs and symptoms possibly linked to low testosterone have been suggested to help doctors reach a diagnosis of hypogonadism. However, in older men it is often challenging to separate out symptoms actually linked to low testosterone from symptoms that may be non-specific or caused by other underlying health conditions. This has made it difficult to know whether a man is likely to benefit from testosterone therapy or if his symptoms are just part of the ‘normal’ aging process.
This problem was tackled by researchers at the University of Manchester, who worked with European partners to ask 3.369 men between the ages of 40 and 79 years in eight European centres details about their sexual, physical and psychological health. They also measured their testosterone levels.
The team started with 32 candidate symptoms and found that only nine were actually linked to low testosterone levels. The three sexual symptoms were the most important of these. Additional symptoms often thought to be associated with late-onset hypogonadism (sometimes incorrectly called the ‘male menopause’) were able to be discounted, including changes in sleeping pattern, poor concentration, feeling worthless, nervousness or anxiety and difficulty getting up from a chair.
The study is important, as it provides good evidence that having all three sexual symptoms, together with low testosterone levels, correctly establishes a diagnosis of late-onset hypogonadism.