Abstract
As its symptoms are non-specific and develop progressively, testosterone deficiency is often misdiagnosed and overlooked. Symptoms may be mild and accepted as normal manifestations of ageing. Some of these symptoms can indeed occur in ageing men who do not have testosterone deficiency. Diagnosis of testosterone deficiency in ageing men can be challenging, as symptoms of testosterone deficiency overlap with those of ’normal’ physiological ageing. GPs’ prescriptions of testosterone have increased significantly over the past decade. An increased awareness among GPs, when coupled with extra demand from patients, is likely to lead to increased prescribing of testosterone. Patient demand has increased with sophisticated drug marketing and guidelines promoting testing and treatment of testosterone deficiency. This article reviews the common clinical features and diagnosis of testosterone deficiency, identifies the risk and benefits of testosterone replacement therapy, and briefly discusses the associated controversies regarding prostate cancer and cardiovascular risk.
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