Many men are familiar with the feeling: lack of motivation, fatigue, difficulty concentrating, or a decreased libido. Often, such symptoms are explained away as stress or the natural aging process. However, in many cases, a hormonal imbalance is the underlying cause – particularly a low testosterone level.
The problem: Testosterone deficiency often goes undetected. This is partly because the symptoms are nonspecific, and partly because men are less likely to discuss their symptoms. However, current data and scientific studies show that the number of affected individuals is high and the health consequences are often underestimated.
Internal evaluation by Adon Health provides initial indications
In 1274 men, the total testosterone level was below the EAU threshold for testosterone deficiency of 12.1 nmol/L – this corresponded to almost 40% of the men tested in our evaluation.
However, this proportion should not be equated with the general prevalence in the population. The analysis is based exclusively on men who volunteered for testing and generally already had symptoms. This leads to selection bias and makes the data not representative of all men in Germany.
However, they provide an important indication of how frequently abnormal values occur in a symptomatic group.
Furthermore, even men with values within the normal range can develop symptoms, for example, if their free testosterone level is low. The number of affected individuals is therefore likely to be significantly higher than the threshold values alone would suggest.
How common is testosterone deficiency really?
International studies show that testosterone deficiency is by no means a rare phenomenon:
- A study in Germany describes a prevalence of around 20% (Araujo et al., 2008).
- An analysis of European data shows a decline in testosterone levels of 20% within two decades, even in young men (Lokeshwar et al., 2021).
- Clinical studies even report that up to 40% of men in the general population may be affected (Mulligan et al., 2006).
These results suggest that millions of men in Germany live with temporarily or permanently reduced hormone levels.
Why this is more than just a lab value
Low testosterone levels are not just a matter of well-being.
A recent study (Yeap et al., 2024) shows that men with low testosterone have an increased risk of overall and cardiovascular mortality .
The healthcare system is also affected. Studies indicate a significant economic impact caused by:
- Increased disease burden
- Secondary diseases such as diabetes, cardiovascular diseases or osteoporosis
- Rising costs due to treatment and follow-up expenses (Pantalone et al., 2021)
Typical symptoms of testosterone deficiency
A testosterone deficiency can affect many areas of life. Frequently reported symptoms include:
- Persistent fatigue and lack of energy
- Declining drive and motivation
- Concentration and memory problems
- Mood swings or depressive moods
- Decreased libido and sexual dysfunction
- Decrease in muscle strength and increase in body fat
These symptoms are nonspecific and can have other causes – therefore, a medical examination is crucial. You can find more information in our blog post: Testosterone deficiency in men: causes, symptoms and solutions
What treatment options are available?
For affected men, this means: complaints should be taken seriously and investigated by a doctor.
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Lifestyle tests can provide initial indications of hormonal fluctuations.
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Further medical examination is always necessary if symptoms are present or test results are abnormal. In addition to general practitioners and specialists such as endocrinologists and urologists, the independent partner physicians of Adon Health, who specialize in hormone level management, can also be a good point of contact. You can find more information on our doctor consultation page.
Scientific studies such as that by Saad et al. (2011) show that targeted testosterone therapy for diagnosed deficiency can lead to an improvement in typical symptoms. Individual medical supervision is crucial!
If you would like to know how severe your symptoms are, our AMS score test offers a non-binding opportunity for self-assessment.
Conclusion
Adon Health's internal analyses indicate that a significant proportion of the men have abnormal testosterone levels.
Combined with the results of international studies, it becomes clear that testosterone deficiency is not a fringe issue, but affects many men – even at a younger age.
Digital services can help to reduce barriers and enable a thorough assessment. However, every diagnosis and treatment decision, including those made at Adon Health, rests solely with independent physicians who conduct an individual evaluation.
Bibliography
- Araujo, AB, Esche, GR, Kupelian, V., O'Donnell, AB, Travison, TG, Williams, RE, Clark, RV, & McKinlay, JB (2008). Prevalence of symptomatic androgen deficiency in men. Clinical Endocrinology , 69(3), 447–458. https://doi.org/10.1111/j.1365-2265.2008.03370.x
- Lokeshwar, SD, Patel, P., Fantus, RJ, Halpern, J., Chang, C., Kargi, AY, & Ramasamy, R. (2021). Decline in Serum Testosterone Levels Among Adolescent and Young Adult Men in the USA. European Urology Focus , 7(6), 1229–1236. https://doi.org/10.1016/j.euf.2020.04.015
- Mulligan, T., Frick, MF, Zuraw, QC, Stemhagen, A., & McWhirter, C. (2006). Prevalence of hypogonadism in males aged at least 45 years: the HIM study. International Journal of Clinical Practice , 60(7), 762–769. https://doi.org/10.1111/j.1742-1241.2006.00992.x
- Yeap, BB, et al. (2024). Mortality risk in men with low testosterone and high luteinizing hormone. Annals of Internal Medicine . https://doi.org/10.7326/M23-2781
- Pantalone, KM, Faiman, C., & Vasan, S. (2021). The burden of testosterone deficiency in adult men: economic and clinical implications. Journal of Men's Health , 17(1), 1–9. https://pmc.ncbi.nlm.nih.gov/articles/PMC7814241/
- Saad, F., Aversa, A., Isidori, AM, Zafalon, L., Zitzmann, M., & Gooren, L. (2011). Onset of effects of testosterone treatment and time span until maximum effects are achieved. European Journal of Endocrinology , 165(5), 675–685. https://doi.org/10.1530/EJE-11-0221
