Many men know the feeling: lack of motivation, fatigue, concentration problems, or declining libido. Such symptoms are often attributed to stress or natural aging. But in many cases, a hormonal imbalance is behind them—particularly a low testosterone level.
The problem: testosterone deficiency often goes undetected. On the one hand, this is because the symptoms are non-specific. On the other hand, men are less likely to discuss their symptoms. Yet 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 clues
In 1,274 men, the total testosterone level was below the threshold for testosterone deficiency established by the EAU of 12.1 nmol/L—this corresponded to just under 40% of the men tested in our evaluation.
However, this figure should not be equated with the general prevalence in the population. The evaluation is based exclusively on men who volunteered to be tested and had usually already experienced symptoms. This leads to a bias (selection bias) and means the data are not representative of all men in Germany.
However, they provide an important indication of how frequently abnormal values occur in a symptomatic group.
In addition, even men with values in the normal range can develop symptoms, for example if the free testosterone level is low. The number of affected individuals may therefore be significantly higher than pure threshold values 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 20% decline in testosterone levels over two decades, even among 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 indicate that millions of men in Germany live with temporarily or permanently low hormone levels.
Why it is more than just a lab value
A low testosterone level is not just a matter of well-being.
A recent study (Yeap et al., 2024) shows: men with low testosterone have an increased risk of all-cause and cardiovascular mortality.
The healthcare system is also affected. Studies point to a significant economic impact, caused by:
- Increased disease burden
- Comorbidities such as diabetes, cardiovascular diseases, or osteoporosis
- Rising costs due to treatment and follow-up care (Pantalone et al., 2021)
Typical symptoms of testosterone deficiency
Testosterone deficiency can affect many areas of life. Frequently mentioned symptoms are:
- Persistent fatigue and lack of energy
- Declining drive and motivation
- Concentration and memory problems
- Mood swings or depressive moods
- Reduced libido and sexual dysfunction
- Loss of muscle strength and increase in body fat
These symptoms are non-specific and can also have other causes—that is why a medical evaluation is crucial. You can find more information about this in our blog post: Testosterone deficiency in men: Causes, symptoms and solutions
What treatment options are available?
For affected men, this means: symptoms should be taken seriously and medically evaluated.
-
Lifestyle tests can provide initial clues about hormonal fluctuations.
-
A further medical examination is always required if symptoms are present or values are abnormal. In addition to general practitioners and specialists such as endocrinologists and urologists, Adon Health's independent cooperating doctors, who specialize in hormone level management, can also be a good point of contact. You can find more information on our page about the doctor's consultation.
Scientific papers such as that by Saad et al. (2011) show that targeted testosterone therapy in diagnosed deficiency can lead to an improvement in typical symptoms. The key is individual medical supervision!
Conclusion
Adon Health's internal evaluations indicate that a significant proportion of men have abnormal testosterone levels.
Combined with the results of international studies, it is clear: testosterone deficiency is not a marginal issue, but affects many men—even at younger ages.
Digital services can help lower barriers and enable a sound evaluation. Every diagnosis and treatment decision, including at Adon Health, rests exclusively with independent doctors who conduct an individual assessment.
Bibliography
- Araujo, A. B., Esche, G. R., Kupelian, V., O'Donnell, A. B., Travison, T. G., Williams, R. E., Clark, R. V., & McKinlay, J. B. (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, S. D., Patel, P., Fantus, R. J., Halpern, J., Chang, C., Kargi, A. Y., & 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, M. F., Zuraw, Q. C., 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, B. B., 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, K. M., 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, A. M., 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
