Changes in Total, Free, Bioavailable, and Calculated Free Testosterone Concentrations in Aging Males and the Frequency of Clinical Symptoms of Androgen Deficiency Syndrome

Background. Decreased testosterone concentration during aging is a generally accepted occurrence. The difficulty is connecting this with clinical symptoms of androgen deficiency, which affect quality of life. Objectives. The aim was to measure total, free, bioavailable, and calculated free testosterone as markers of clinical symptoms of androgen deficiency syndrome on the Heinemann Aging Males' Symptoms scale. Material and Methods. The study comprised 268 randomly selected men aged 45-65 years from whom blood samples were taken for testosterone measurement. The AMS quality-of-life scale was used. Results. There was negative correlation between age and the concentrations of free, bioavailable, and calculated free testosterone. No correlation between age and total testosterone concentration was found nor between total, free, bioavailable, and calculated free testosterone concentration and the results of the general AMS scale and its three subscales. There were no differences in total, free, bioavailable, and calculated free testosterone concentrations in men with and without symptoms of androgen deficiency. There were no differences in AMS in the men with low and normal concentrations of total and free testosterone. Conclusions. The data indirectly confirm that androgen deficiency syndrome appearing during male aging has a complex etiology and the assumption that it arises mainly due to androgen deficiency is a simplification. Therefore the relationships between testosterone level and clinical symptoms of androgen deficiency syndrome are uncertain (Adv Clin Exp Med 2009, 18, 3, 261-268).