Late-Onset Hypogonadism

What is late-onset hypogonadism?

Late-onset hypogonadism is also called LOH, androgen deficiency, or testosterone deficiency syndrome (TDS.)

It is when men, usually over 50, have lower levels of testosterone, the male sex hormone. A small amount of loss is natural due to aging, but LOH causes symptoms that may be severe and can interfere with quality of life.

Testosterone is needed to maintain the male reproductive system, but it also influences many other functions including metabolism, bone density, muscle strength and formation, and clear thinking.

LOH is most often caused by a direct loss of functioning in the testicles from the combination of aging and other illnesses, especially those which interfere with circulation such as obesity, diabetes, or heart disease.

It may also be caused by malfunction in the hypothalamus or pituitary glands in the brain, which control hormone levels.

The epidemiology of late-onset hypogonadism reveals a significant prevalence among older men. Studies have shown that the condition becomes more common with advancing age, affecting an estimated 10% of men over 50 years old and up to 20% of men over 60. More specifically, research indicates that approximately 20% of men in their 60s and 30% of men in their 70s have low testosterone levels. However, the prevalence of symptomatic late-onset hypogonadism, where both low testosterone and clinical symptoms are present, is lower, affecting around 5% of men between 70 and 79 years old. With the global population aging rapidly, the World Health Organization projects that the number of men over 65 will increase from 520 million in 2000 to over 1.5 billion by 2050. Consequently, the prevalence of late-onset hypogonadism is expected to rise significantly, making it an increasingly important health concern for aging men.

Symptoms include erectile dysfunction and a decrease in libido, muscle strength, and energy. Osteoporosis is also a risk.

Rarity: Common

Top symptoms

• Fatigue
• Difficulty concentrating
• Trouble sleeping
• Depressed mood
• Irritability

Treatment

See a primary care doctor. Diagnosis is made through patient history and blood tests. Treatment involves testosterone replacement therapy, which usually has very positive effects.