Testosterone plays an important role in health and disease, affecting energy and libido, erectile dysfunction, cardiovascular disease, metabolic syndrome, diabetes, memory-loss, osteoporosis, prostate health, modulation of stem cell activity and premature death. Testosterone replacement therapy (TRT) can influence these, so it is important to be able to recognise testosterone deficiency syndrome (TDS) which is defined as an absolute or relative deficiency of testosterone or its metabolites according to the needs of that individual at that time in his life. Reduced testosterone levels have somatic, psychological and sexual effects and their recognition is important in reaching a diagnosis.
There is poor correlation between the symptoms of testosterone deficiency syndrome and blood androgen levels. It is important to fully assess each patient, document the diagnosis as fully as possible and actively look for aetiologies and complications of testosterone deficiency. Testosterone deficiency can be easily and safely treated and since treatment is often life-long, a careful structured approach to assessment is needed.