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Talking testosterone
deficiency (TD)

Talking Testosterone Deficiency

Ageing and testosterone

Testosterone levels decline with age – what is normal?

Ageing and testosterone

Total testosterone
levels between
12–35 nmol/L are
considered within the
healthy range for men
of any age.1

Testosterone levels normally decline (within a healthy range) as men age

This is due to a combination of reduced hypothalamic-pituitary and testicular (HPT) function, the key mediators of testosterone production, throughout the ageing process.

In some men, testosterone levels will drop below what is healthy throughout the normal course of ageing. A decrease in total testosterone levels to below 12 nmol/L when signs and symptoms TD are present denotes the clinical syndrome of TD.2

In men with TD, testosterone levels are abnormally low which affects their overall health and causes symptoms of varying severity. Check clinical guidelines on when to treat TD.

Symptomatic men with a total testosterone level of 12 nmol/L or above do not usually require testosterone therapy.1 However, when total testosterone levels are borderline or low to normal, particularly in obese or ageing men, sex hormone binding globulin (SHBG) levels should be assessed. When men have elevated SHBG levels, free testosterone levels should also be assessed to determine if testosterone therapy is required.2


  1. Men’s Health Review Panel. Men’s Health Handbook for General Practice. Toronto: MUMS Guideline Clearinghouse; 2019.
  2. Hackett G, Kirby M, Edwards D, et al. British Society for Sexual Medicine Guidelines on Adult Testosterone Deficiency, With Statements for UK Practice. J Sex Med. 2017;14(12):1504–1523.

TES/2020/009. April 2021.

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