epidemiology

Last edited 05/2018 and last reviewed 06/2023

Epidemiology

Estimates of TD prevalence vary widely, with epidemiological research being complicated by differences in study populations, methodology, type of testosterone used (total, free or bioavailable), timing of tests, assay techniques, and diagnostic criteria.1

The European Male Aging Study (EMAS) evaluated 3,369 men aged 40-79 years according to biochemistry and symptoms. TD was defined as the presence of 3 or more sexual symptoms, associated with a total testosterone less than 11 nmol/L and a free testosterone less than 0.22nmol/L.2

TD prevalence was 2.1% overall, and rates increased with age, from 0.1% in men aged 40-49, to 0.6% in men aged 50-59, 3.2% in men aged 60-69 and 5.1% in men aged 70-79.2

When considering testosterone levels in isolation, (as opposed to the combination of low testosterone levels with relevant symptoms), more than 70% of men maintained normal testosterone levels into older age, which suggests that TD is not solely related to aging.3

The prevalence of primary TD was 2%, secondary TD 11.8% and compensated (subclinical) TD 9.5%.3

Reference:

• 1. Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's process of care for the assessment and management of testosterone deficiency in adult men. J Sex Med 2015;12:1660-1686.
• 2. Wu FCW, Tajar A, Beynon JM, et al; EMAS Group. Identification of late-onset hypogonadism in middle aged and elderly men. N Engl J Med 2010;363:123-135.
• 3. Tajar A, Forti G, O'Neill TW, et al. Characteristics of secondary, primary, and compensated hypogonadism in aging men: evidence from the European Male Ageing Study. J Clin Endocrinol Metab 2010;95:1810-1818.