Male hypogonadism is defined as a clinical syndrome complex, which comprises symptoms—with or without signs—and biochemical evidence of testosterone deficiency. Longitudinal population studies show that testosterone concentrations gradually decline with age.1 One recent study reported the prevalence of hypogonadism to be 4.2% between 30 and 50 years and 8.4% between 50 and 79 years, although other studies have indicated that it may be higher.2

The terminology to explain the development of hypogonadism with ageing is controversial. Terms such as male menopause and andropause imply that all men develop this condition, which is not the case. The term late onset hypogonadism has been proposed as a clearer clinical description and is now the preferred terminology of several major international societies.3 Late onset hypogonadism is defined as “a clinical and biochemical syndrome associated with advancing age and characterised by typical symptoms and a deficiency in serum testosterone levels. It may significantly reduce quality of life and adversely affects the function of multiple organ systems.”3 A diagnosis of late onset hypogonadism can …