Androgen deficiency in the aging man is an area of considerable debate because a
gradual decline in testosterone may simply be part of the normal aging process. However,
there is an alternative view that androgen deficiency in the aging man may constitute a
valid and underdiagnosed disorder.
To discuss the aetiology, clinical features, diagnosis and management of androgen
deficiency in the aging man.
Late onset hypogonadism has clinical features that overlap with both normal aging and
some pathological conditions. It can only be diagnosed on the basis of both suggestive
clinical features and clear biochemical evidence of testosterone deficiency. In this group
of patients medication may play a role.
The issue of androgen deficiency in the aging man continues to generate considerable discussion because a gradual decline in testosterone may be only a part of the normal aging process and may not represent a true clinical entity.1–3 However, there is a possibility that androgen deficiency in the aging man constitutes a valid disorder.4 From data available on diagnostic criteria of symptoms and low testosterone levels, the prevalence of symptomatic androgen deficiency may be up to 12% in males older than 40 years of age.5
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