Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Andrology

Testosterone reference ranges and diagnosis of testosterone deficiency

Determining what constitutes a low level of testosterone is a major point of confusion in the field of testosterone deficiency — also known as hypogonadism. A recent article adds to the controversy by proposing a new, lower threshold for normal testosterone concentrations on the basis of harmonized reference ranges.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. Travison, T. G. et al. Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the USA and Europe. J. Clin. Endocrinol. Metab. http://dx.doi.org/10.1210/jc.2016-2935 (2017).

  2. Bhasin, S. et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 91, 1995–2010 (2006).

    CAS  Article  Google Scholar 

  3. Wang, C. et al. Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur. Urol. 55, 121–130 (2009).

    Article  Google Scholar 

  4. Bhasin, S. et al. Reference ranges for testosterone in men generated using liquid chromatography tandem mass spectrometry in a community-based sample of healthy nonobese young men in the Framingham Heart Study and applied to three geographically distinct cohorts. J. Clin. Endocrinol. Metab. 96, 2430–2439 (2011).

    CAS  Article  Google Scholar 

  5. Bhasin, S. et al. Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 95, 2536–2559 (2010).

    CAS  Article  Google Scholar 

  6. Lazarou, S., Reyes-Vallejo, L. & Morgentaler, A. Wide variability in laboratory reference values for serum testosterone. J. Sex. Med. 3, 1085–1089 (2006).

    CAS  Article  Google Scholar 

  7. Antonio, L. et al. Low free testosterone is associated with hypogonadal signs and symptoms in men with normal total testosterone. J. Clin. Endocrinol. Metab. 101, 2647–2657 (2016).

    CAS  Article  Google Scholar 

  8. Aversa, A. & Morgentaler, A. The practical management of testosterone deficiency in men. Nat. Rev. Urol. 12, 641–650 (2015).

    CAS  Article  Google Scholar 

  9. Morgentaler, A. et al. Fundamental concepts regarding testosterone deficiency and treatment: international expert consensus resolutions. Mayo Clin. Proc. 91, 881–896 (2016).

    Article  Google Scholar 

  10. Morgentaler, A., Khera, M., Maggi, M. & Zitzmann, M. Commentary: who is a candidate for testosterone therapy? A synthesis of international expert opinions. J. Sex. Med. 11, 1636–1645 (2014).

    CAS  Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abraham Morgentaler.

Ethics declarations

Competing interests

A.M. has received payments for consulting or lecture honoraria from AbbVie, Aytu, Bayer and BioTE.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Morgentaler, A. Testosterone reference ranges and diagnosis of testosterone deficiency. Nat Rev Urol 14, 263–264 (2017). https://doi.org/10.1038/nrurol.2017.35

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrurol.2017.35

Further reading

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing