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T is now well accepted that serum testosterone (T) levels decline progressively with aging in men (1-5). This de- cline is associated with alterations in body composition; di- minished energy, muscle strength, and physical function; reduced sexual function; depressed mood; and decreased cognitive function. Similar changes occur in young men with androgen deficiency and are improved with T replace- ment therapy. However, the physiological and clinical sig- nificance of the aging-associated decline in serum T levels in men is unclear, particularly because T levels may remain within the normal range for young men. From a practical clinical standpoint, it is most appropriate to define "andro- pause" as an age-related decline in serum T levels in older men to below the normal range in young men that is associ- ated with a clinical syndrome (i.e., symptoms and signs) consistent with androgen deficiency. The decline in T levels is a consequence both of aging per se and age-associated co- morbid illnesses and medications that are used to treat them

Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men