Hypogonadism in Elderly Men — What to Do Until the Evidence Comes

Testosterone treatment for elderly men made the news again recently, when the Institute of Medicine Committee on Assessing the Need for Clinical Trials of Testosterone Replacement Therapy issued its long-awaited report,1 which concluded that there is insufficient evidence that testosterone treatment benefits elderly men. What is the background behind this report, and what are its implications?Many studies document that serum testosterone concentrations in men decrease as they age. In contrast to the precipitous and profound decrease in estradiol concentrations that occur when women enter menopause, the decrease in testosterone in men occurs moderately and gradually over a period of . . .