Prevalence of hypogonadism in males aged at least 45 years: the HIM study.
Level 4 - case-series / case-control
Multicenter cross-sectional prevalence study
PubMed 16846397 · doi:10.1111/j.1742-1241.2006.00992.x
What was done
The Hypogonadism in Males (HIM) study estimated the prevalence of biochemical hypogonadism (total testosterone < 300 ng/dL) in 2,162 men aged 45 years or older visiting primary care practices across the United States. Blood samples were drawn between 8:00 AM and noon to measure total testosterone, free testosterone, and bioavailable testosterone. Investigators also recorded demographics, reasons for visit, symptoms, and comorbid medical conditions.
What was found
Of 2,162 patients, 836 were hypogonadal (crude prevalence rate 38.7%), including 80 who were receiving testosterone therapy. Similar trends were observed for free and bioavailable testosterone. Among men not receiving testosterone therapy, 756 of 2,082 (36.3%) were hypogonadal. Odds ratios for hypogonadism were significantly higher in men with obesity (OR 2.38), diabetes (OR 2.09), hypertension (OR 1.84), hyperlipidaemia (OR 1.47), asthma or chronic obstructive pulmonary disease (OR 1.40), and prostate disease (OR 1.29).
Why it matters
This study provides an estimate of low testosterone prevalence in routine primary care settings and demonstrates its strong association with common metabolic and respiratory comorbidities.
Limits
The study sample was restricted to patients already attending primary care clinics, which may overestimate prevalence relative to the general population. Diagnoses relied on a single morning blood sample rather than repeat confirmatory testing, and the cross-sectional design cannot establish causality between comorbidities and hypogonadism.
Cited by
- context Between 20% and 40% of men have low testosterone, but only about 2% of men receive treatment.