Systematic Literature Review of the Epidemiology of Nongenetic Forms of Hypogonadism in Adult Males

Table 2

Prevalence of hypogonadism in population-, community-, and primary care or screening-based populations.

Author, year, and study name	Country and years of data collected	Study design	𝑁	Age, mean (SD), and range	Definition of hypogonadism used	Reported prevalence (%)
Population-based studies
Haring et al., 2010 [5] (SHIP)	Germany, 1997–2001	Population-based	1490	50.65 (15.41), NR	TT < 300 ng/dL	12.8
Araujo et al., 2007 [3] (BACH)	USA, 2002–2005	Population-based	1475	47.3 (12.5), NR	TT < 300 ng/dL +; FT < 5 ng/dL +; ≥1 specific symptom or ≥ 2 nonspecific symptoms^†	5.6
Araujo et al., 2004 [2] (MMAS)	USA, 1987–1997	Population-based	1691	NR (NR), 40–70**	TT < 200 ng/dL +; ≥3 symptoms^††; OR: TT 200–400 ng/dL +; FT< 8.91 ng/dL +; ≥ 3 symptoms^††	6
Tajar et al., 2012 [4] (EMAS)	8 European countries, 2003–2005	Population-based^†††	2966	59.15 (10.82), 40–79	TT < 317 ng/dL +; 3 specific symptoms*	2.1
Community-based studies
Ponholzer et al., 2010 [6]	Austria, 2000–2002	Community-based	247	75.8 (0.4), 75–78	TT < 350 ng/dL	31.2
Khoo et al., 2008 [7]	Malaysia, NR	Community-based	351	58 (7), 50–93	TT < 317 ng/dL	19.1
					TT < 317 ng/dL +; positive symptoms on ADAM	6
Wong et al., 2006 [8]	China (Hong Kong), 2003-2004	Community-based	252	54 (NR), 45–64	TT < 200 ng/dL +; ≥3 of 7 symptoms; OR: TT 200–400 ng/dL +; FT < 0.3093 nmoL/L +; ≥3 of 7 symptoms	9.52
Primary care and screening studies
Mulligan et al., 2006 [13] (HIM)	USA, 2003-2004	Primary care patients	2162	60.5 (10.33), 45–96	TT < 300 ng/dL	38.7
Schneider et al., 2009 (DETECT) [15]	Germany, 2003	Primary care patients	2719	58.7 (13.4), NR	TT < 300 ng/dL	19.3
Nardozza et al., 2011 [14]	Brazil, 2009	Health screening	1623	57 (NR), 24–87	TT < 300 ng/dL	19.8
Goel et al., 2009 [11]	India, 2006	Health Screening^††††	157	53.1 (NR), 40–60;	TT < 300 ng/dL	24.2
					TT < 300 ng/dL +; Symptoms	20.4
Liu et al., 2009 [12]	Taiwan, 2007-2008	Health screening	734	57.4 (6.7), 43–87	TT < 300 ng/dL	24.1
					TT < 300 ng/dL +; FT < 5 ng/dL + symptoms	12
Blümel et al., 2009 [9]	Chile, NR	Primary care patients	96	55.1 (12.0), 40–85	BT <198.4 ng/dL +; symptoms***	28.1
Di Luigi et al., 2010 [10]	Italy	Health screening	183	61.9 (7.5), 50–75	TT < 230 ng/dL	12

TT: 200 ng/dL = 6.94 nmol/L; 230 ng/dL = 8 nmol/L; 300 ng/dL = 10.4 nmol/L; 317 ng/dL = 11 nmol/L; 350 ng/dL = 12 nmol/L; FT: 5 ng/dL = 0.17 nmol/L; 8.9 ng/dL = 0.3092 nmoL/L.
ADAM: androgen deficiency in the aging male; BACH: Boston Area Community Health; BT: bioavailable testosterone; cFT: calculated free testosterone; DETECT: diabetes cardiovascular risk-evaluation: targets and essential data for commitment of treatment; EMAS: European Male Aging Study; HIM: hypogonadism in males; MMAS: Massachusetts Male Aging Study; NR = not reported; SHIP = Study of Health in Pomerania; TT = total testosterone.
*Decreased frequency of morning erections, sexual thoughts, and erectile dysfunction.
**Participants were equally divided between men in their 40s, 50s, and 60s with a similar mean age to the BACH data.
***Positive answer to items 1 or 7, or any 3 other questions on the ADAM questionnaire.
^†Specific symptoms include low libido, erective dysfunction, or osteoporosis; the nonspecific symptoms include sleep disturbance, depressed mood, lethargy, or low physical performance.
^††Symptoms include loss of libido, erectile dysfunction, depression, lethargy, inability to concentrate, sleep disturbance, irritability, and depressed mood.
^†††4.4% of original population were excluded which included men already receiving testosterone replacement therapy.
^††††Study subjects were healthy hospital employees volunteered for a health check-up.