Unlike female menopause, male reproductive aging is gradual and heterogeneous. Testosterone levels decline progressively with age, accompanied by reduced sperm motility and increased DNA fragmentation.
Age-related hormonal adaptation may also involve increased SHBG levels, resulting in decreased bioavailable testosterone. Symptoms can include reduced libido, decreased muscle mass, mood changes, and fatigue.
Diagnosis of late-onset hypogonadism requires both symptomatic presentation and laboratory confirmation of consistently low testosterone levels. Lifestyle optimization often improves hormonal balance.
Testosterone therapy in older men remains controversial and must be individualized based on risk–benefit analysis and guideline recommendations from organizations such as the Endocrine Society.
Understanding reproductive aging enables clinicians to erotic distinguish physiological decline from pathological hypogonadism.
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