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Sokol RZ – Endogenous testosterone levels decline with aging; however, those levels rarely fall below the normal range for healthy young men. Current data do not provide adequate information on the value of testosterone below which the clinical features and adverse consequences of androgen deficiency occur in the aging male. Future evidence–based studies should lead to a better delineation of the syndrome and guidelines for testosterone replacement in the aging man. Based on a review of the current literature, the treatment of aging men with androgen replacement should be restricted to men with consistent signs and symptoms of androgen deficiency who have repeated documented low serum testosterone levels using reliable assays with validated reference ranges, and do not have any contraindication to initiation of therapy. If treatment is initiated, the patient should be carefully monitored.

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