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In various Western and Non-Western countries, serum testosterone levels in males have declined substantially in the past century.<ref>https://pubmed.ncbi.nlm.nih.gov/17062768/</ref> Today, U.S. men have 30% lower T levels compared to 1987, affecting all age groups similarly.<ref>https://www.forbes.com/sites/neilhowe/2017/10/02/youre-not-the-man-your-father-was/</ref><ref>https://www.healio.com/endocrinology/hormone-therapy/news/print/endocrine-today/%7Bac23497d-f1ed-4278-bbd2-92bb1e552e3a%7D/generational-decline-in-testosterone-levels-observed</ref> | In various Western and Non-Western countries, serum testosterone levels in males have declined substantially in the past century.<ref>https://pubmed.ncbi.nlm.nih.gov/17062768/</ref> Today, U.S. men have 30% lower T levels compared to 1987, affecting all age groups similarly.<ref>https://www.forbes.com/sites/neilhowe/2017/10/02/youre-not-the-man-your-father-was/</ref><ref>https://www.healio.com/endocrinology/hormone-therapy/news/print/endocrine-today/%7Bac23497d-f1ed-4278-bbd2-92bb1e552e3a%7D/generational-decline-in-testosterone-levels-observed</ref> | ||
Similarly, a Danish study found male cohorts born in the 1960s have on average 14 percent lower testosterone levels than males from the 1920s.<ref>https://academic.oup.com/jcem/article/92/12/4696/2597312</ref> An Israeli study found a similar secular decline as well.<ref>Chodick, G., Epstein, S., & Shalev, V. (2020). Secular trends in testosterone- findings from a large state-mandate care provider. Reproductive Biology and Endocrinology, 18(1). doi:10.1186/s12958-020-00575-2 </ref> Testosterone supplement prescriptions have doubled from 2010 to 2013 in the U.S.<ref>http://jamanetwork.com/journals/jama/article-abstract/2612615</ref> | Similarly, a Danish study found male cohorts born in the 1960s have on average 14 percent lower testosterone levels than males from the 1920s.<ref>https://academic.oup.com/jcem/article/92/12/4696/2597312</ref> An Israeli study found a similar secular decline as well.<ref>Chodick, G., Epstein, S., & Shalev, V. (2020). Secular trends in testosterone- findings from a large state-mandate care provider. Reproductive Biology and Endocrinology, 18(1). doi:10.1186/s12958-020-00575-2 </ref> Testosterone supplement prescriptions have doubled from 2010 to 2013 in the U.S.<ref>http://jamanetwork.com/journals/jama/article-abstract/2612615</ref> In a study from 2018, 409 male students a staggering 35% met the criteria for androgen deficiency based on a survey instrument designed to assess older males,<ref name="charlier2018">https://www.mdpi.com/2227-9032/6/4/121</ref> and the score on this survey instrument significantly correlated with stress levels and poor sleep quality, which are considered symptoms of androgen deficiency. | ||
Some of this trend can be attributed the aging population due to older males exhibiting lower testosterone levels. Various comorbidities, including diabetes and obesity are known to decrease testosterone levels, and these conditions have become more prevalent over time.<ref>https://www.urologytimes.com/view/testosterone-levels-show-steady-decrease-among-young-us-men</ref><ref>J Clin Endocrinol Metab. 2006:doi10.1210/jc.2006-1859</ref> But even after controlling for confounders like age, race, BMI and comorbidities, alcohol consumption, smoking, and physical activity, total T level still decreased highly significantly (p < 0.0001) from 605.39 ng/dL 1999-2000, 567.44 ng/dL in 2003-2004, 424.96 ng/dL in 2011-2012, 431.76 ng/dL in 2013-2014, to 451.22 ng/dL in 2015-2016, with average levels declining by about 1% per year. Obesity has been specifically ruled out as a sufficient primary explanation for the trend.<ref>https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0076178</ref> | Some of this trend can be attributed the aging population due to older males exhibiting lower testosterone levels. Various comorbidities, including diabetes and obesity are known to decrease testosterone levels, and these conditions have become more prevalent over time.<ref>https://www.urologytimes.com/view/testosterone-levels-show-steady-decrease-among-young-us-men</ref><ref>J Clin Endocrinol Metab. 2006:doi10.1210/jc.2006-1859</ref> But even after controlling for confounders like age, race, BMI and comorbidities, alcohol consumption, smoking, and physical activity, total T level still decreased highly significantly (p < 0.0001) from 605.39 ng/dL 1999-2000, 567.44 ng/dL in 2003-2004, 424.96 ng/dL in 2011-2012, 431.76 ng/dL in 2013-2014, to 451.22 ng/dL in 2015-2016, with average levels declining by about 1% per year. Obesity has been specifically ruled out as a sufficient primary explanation for the trend.<ref>https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0076178</ref> | ||