OBJECTIVE To investigate the association between serum sex hormone levels and lower urinary tract symptoms in men aged 40-79 years. METHODS A cross-sectional study was conducted in 509 men (mean age 58 years). The serum total testosterone (TT), dihydrotestosterone, and estradiol levels were measured. The total prostate volume measured by transrectal ultrasonography and International Prostate Symptom Score (IPSS) questionnaire were obtained. Correlations were determined using univariate and multi-variate regression analysis. RESULTS The subjects with moderate to severe lower urinary tract symptoms (total IPSS >= 8) were older, with a greater incidence of hypertension and diabetes, a larger prostate, and had lower serum TT levels. On the univariate analysis, the serum TT levels were negatively associated with the total IPSS, IPSS storage subscore, weak stream, and nocturia. After adjusting for age, hypertension, diabetes, and total prostate volume, only the serum TT level was significantly associated with nocturia (>2 times/night; P = .042), and men with serum TT levels in the greatest quartile had a 44% reduced risk of nocturia than in the lowest quartile (P = .037). CONCLUSION In our relative healthy male cohort, most IPSS items showed no significant association with serum sex hormone levels, except for nocturia, which showed a negative correlation with the serum testosterone level. UROLOGY 78: 631-635, 2011. (C) 2011 Elsevier Inc.