Abstract
Aim: To establish norms for reproductive hormones in healthy males with normal urologic and sexual function, and to assess the change in reproductive hormone levels with respect to age among healthy males. Methods: Healthy volunteers aged 18 - 29 (group 1) and 45 - 65 (group 2) were recruited for enrollment in a prospective study. Inclusion criteria comprised normal urinary, ejaculatory, orgasmic, and erectile function, as determined by IPSS, MSHQ, and IEFF-15. Men with history of chronic medical illnesses or chronic medication use were excluded. Fifty men met the study criteria. Each participant underwent physical examination and standardized serum hormone evaluation using ELISA and EIA methods. Statistical analysis was performed using JMP 8.0 software (SAS Institute Inc., Cary, NC), to compare hormone levels between the two groups of men. Results: There were 25 men each in groups 1 (mean age 26) and 2 (mean age 51). Overall, 46% were Caucasian, 31% African American, 15% Hispanic, and 8% Asian. There was no statistically significant difference in serum total T, SHBG, E2, or LH between groups 1 and 2. Notably, the 95% CI for serum T levels for both groups of men were considerably higher than commonly accepted lower-end cut-off limits. Conclusion: Serum T levels do not vary significantly with age, in otherwise healthy men with normal sexual and urologic function. Furthermore, healthy men have much higher serum total and free T levels than the lower-end reference limits provided by commercial laboratories.
Highlights
Hypogonadism is a clinical condition characterized by low levels of serum testosterone (T), in association with specific signs and symptoms of low T, which may include physical, sexual, reproductive, and cognitive effects
When hypogonadism occurs in older men, the condition is often called andropause, or androgen deficiency of the aging male [2]
Our results demonstrate that serum testosterone levels are not significantly different in healthy men between the second and sixth decades of life
Summary
Hypogonadism is a clinical condition characterized by low levels of serum testosterone (T), in association with specific signs and symptoms of low T, which may include physical, sexual, reproductive, and cognitive effects. Hypogonadism affects an estimated two to four million men in the United States; its prevalence increases with age [1]. When hypogonadism occurs in older men, the condition is often called andropause, or androgen deficiency of the aging male [2]. Testosterone replacement therapy (TRT) results in a demonstrable improvement in symptoms of hypogonadism, including diminished libido, energy and well-being, impaired cognition, decreased muscle mass/ strength, anemia, osteoporosis, erectile dysfunction, and visceral obesity [4,5,6,7,8,9,10,11,12,13]. At present there is no universally accepted definition of hypogonadism, no universally used assay for the analysis of serum T, and no universally agreed-upon indications for the initiation and use of TRT
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