OBJECTIVE: To investigate the association between hypogonadal symptoms and total serum testosterone levels in young men (< 40 years of age) with an attempt to determine whether there exists a clear-cut discriminatory threshold of total testosterone below which hypogonadal symptoms become more prevalent.
PATIENTS AND METHODS: We retrospectively reviewed the charts of 352 men who presented to an outpatient Men's Health Clinic with chief complaint of "low testosterone". Sexual, psychological and physical symptoms were evaluated using the Androgen deficiency in Aging Male (ADAM) questionnaire. Serum levels of total testosterone were collected on the same day that men completed their ADAM questionnaires. We subsequently performed univariate (t test, chi-square) and multivariate analyses (ordinal logistic regression) to evaluate factors that predicted a low testosterone level.
RESULTS: The probability of hypogonadal symptoms increased at a serum total testosterone level of 400ng/dL. A cluster of symptoms: two psychological (decreased energy, sadness), and three physical (decreased strength and endurance, decreased ability to play sports, and deterioration in work performance) were most strongly associated with total serum testosterone levels of < 400 ng/dL. On multivariable analysis, only 'lack of energy' predicted a total testosterone of less than 400ng/dL.
CONCLUSIONS: Hypogonadal symptoms in men < 40 years of age can be associated with a total testosterone level of less than 400ng/dL. Of the hypogonadal symptoms evaluated with the ADAM questionnaire, lack of energy appears to be the most important symptom that predicts a total testosterone level < 400ng/dL.
Written by:
Scovell JM, Ramasamy R, Wilken N, Kovac JR, Lipshultz LI. Are you the author?
Department of Urology, Baylor College of Medicine, Houston, TX.
Reference: BJU Int. 2014 Oct 23. Epub ahead of print.
doi: 10.1111/bju.12970
PubMed Abstract
PMID: 25345995