Of 32 possible symptoms, only nine were linked with decreased testosterone levels. Three were physical -- not being able to engage in strenuous physical activity, not being able to walk more than 1 kilometer and not being able to bend over or kneel -- and three were psychological -- low energy, sadness and fatigue.
But these six symptoms were only peripherally linked to low testosterone levels.
Three sexual symptoms -- less frequent morning erections, lower sex drive and erectile dysfunction -- were more robustly related to testosterone levels.
Men need to have all three sexual symptoms plus measurably lower levels of testosterone to qualify for the diagnosis of late-onset hypogonadism, the authors stated.
But even with this new diagnostic criteria, the challenge of treating men with sexual and other symptoms of male menopause is still far from straightforward.
"These symptoms that are associated with hypogonadism are not necessarily going to be treated by testosterone therapy," pointed out Dr. Natan Bar-Chama, director of male reproductive medicine and an associate professor of urology at Mount Sinai Medical Center in New York City. "We know very well that erectile dysfunction is complicated. It's associated with other co-morbidities and the ability to regain normal erectile function is often not successfully treated with just testosterone."
"Just because an older guy comes in and says he has a bad sex life, you don't automatically give him testosterone," Hermans added.
And even though there are any number of testosterone products available -- from patches to pellets -- there isn't much research on how much they really help men, Hermans said, or whether they are safe.
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