Testosterone Deficiency in the Older Male

Testosterone deficiency (TD) in the older male is a difficult diagnosis to make with potentially life changing treatment. Awareness of the normal hormonal pathways, and an understanding of the corrective homeostatic mechanisms, can help in understanding the downstream effects of potential physiologic disturbances. Depending on age, the signs and symptoms of TD can vary from under developed external genitalia in the fetus, to lack of normal pubertal changes in the young adolescent up to an alteration in certain masculine physical characteristics present in the normal adult male. For the adult male, multiple treatment options are available, with newer ones being refined and developed. Monitoring for effective response to Testosterone Replacement Therapy (TRT) and screening for complications is not an onerous task and has the potential to improve the lives of many men.