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

Table 4

Prevalence of hypogonadism by age.

Author and year (study name)	Country and years of data collected	Study design	𝑁	Age, mean (SD), and range	Definition of hypogonadism used	Prevalence, per age group, years (%)
Harman et al., 2001 (BLSA) [17]	USA, 40-year period	Population-based	890	53.8 (16.0), NR	TT < 325 ng/dL; OR; FT < 0.153 nmol/L	20–29	<5
						30–39	<5
						40–49	<10
						50–59	12
						60–69	19
						70–79	28
						>80	49^a
Wu et al., 2010 [19] (EMAS)	8 European countries,; 2003–2005	Population-based	2966	59.15 (10.82), 40–79	TT < 317 ng/dL +; FT < 220 pmol/L +; ≥3 sexual symptoms^#	40–49	0.1
						50–59	0.6
						60–69	3.2
						70–79	5.1^b
Araujo et al., 2007 [3] (BACH)	USA, 2002–2005	Population-based	1475	47.3 (12.5)	TT < 300 ng/dL +; FT < 5 ng/dL +; ≥1 specific symptom or ≥2 nonspecific symptoms^†	30–39	1.1
						40–49	4.1
						50–59	8.1
						60–69	9.1
						70–79	22.1^c
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^††	40–49	4.1
						50–59	4.5
						60–70	9.4^d
Li et al., 2005 [18]	China, 2002-2003	Population-based study	1080	NR (NR), 20–>70	cFT < 0.3 nmol/L	40–49	13.0
						50–59	31.8
						60–69	30.1
						>70	46.7^e
Wong et al., 2006 [8]	China, 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	45–49	8.2
						50–54	6.3
						55–59	10
						60–65	16.7^f
Mulligan et al., 2006 [13] (HIM)	USA, 2003-2004	Primary care patients	2162	60.5 (10.33), 45–96	TT < 300 ng/dL	45–54	34
						55–64	40.2
						65–74	39.9
						75–84	45.5
						85+	50
						50–54	6.33
						55–59	10
						60–64	16.67^g
Liu et al., 2009 [12]	Taiwan, 2007-2008	Health screening clinic in a medical center	734	57.4 (6.7), 43–87	TT < 300 ng/dL	40–49	16.5
						50–59	23
						60–69	28.9
						≥70	37.2^h
Di Luigi et al., 2010 [16]	Italy, NR	Health screening clinic*	183	61.9 ± 7.5 years (range 50–75).	TT < 230 ng/dL	50–59	5.4
						60–69	10
						70–79	27.5^i
Blümel et al., 2009 [9]	Chile, NR	Primary care-based (health services center)	96	55.1 ± 12.0 years (range 40–85 years)	BT < 198.4 ng/dL +; symptoms**	40–54	17.9
						55–69	29.2
						≥70	66.7^j

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; 325 ng/dL = 11.3 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; 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.
^aNo statistical test done; ^bno statistical test done; ^call pairwise comparisons, 𝑃<0.05 over 70 versus all other age groups; ^d𝑃 values for trend <0.001; ^echi square 𝑃<0.000; ^fnot significant; ^gno statistical test done; ^h𝑃<0.019 for trend; ⁱ𝑃<0.01 versus age 50–59 and age 60–69; ^j𝑃 value for trend 𝑃<0.0004.
^†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.
^#Specific signs/symptoms are low libido, erectile dysfunction, or osteoporosis.
*To evaluate risks associated with participation in sports in a group of healthy athletic men.
**Positive answer to items 1 or 7, or any 3 other questions on the ADAM questionnaire.