Prevalence
Most elderly men have testosterone levels within the normal range, with prevalence estimates of “low” (eg, < 300 ng/dL (10.4 nmol/L)) serum testosterone generally between 10% and 25%. 66 , 70 More appropriate prevalence estimates also account for presence of clinical symptoms. Data from the MMAS indicate that the prevalence of symptomatic hypogonadism is between 6%–12%, 71 which is similar to prevalence in the Boston Area Community Health (BACH) Survey (5.6%), 52 suggesting that there could be up to 4.7 million men American men 30–79 years with symptomatic hypogonadism.
Wu and colleagues 51 estimated the prevalence of hypogonadism in the EMAS, defined as the presence of at least 3 sexual symptoms (loss of morning erections, low sexual desire, and erectile dysfunction), total testosterone < 320 ng/dL (11 nmol/L), and free testosterone < 64 pg/mL (220 pmol/L). Using this definition, the overall prevalence of hypogonadism in the EMAS study population was 2.1% and increased with age from 0.1% for men 40 to 49 years of age to 5.1% for those 70 to 79 years.