2 Awareness and prevalence of the symptoms of testosterone deficiency: a cross-sectional survey of community-dwelling men in the UK 1. Background and Aim Testosterone deciency (TD), also known as low testosterone or male hypogonadism, is a condition associated with symptoms that can affect sexual health, physical performance, energy levels and psychological well-being. The clinical diagnosis is based on symptoms and morning serum testosterone levels. Despite its potential impact on quality of life, testosterone deciency may remain undiagnosed because its symptoms are often non-specic and men may not recognise them as possible signs of a hormonal problem. The age-related physiological changes attributable to low testosterone has received renewed interest in the last few years with the availability of testosterone replacement therapy (TRT) and the publication of the TRAVERSE study which demonstrated the relative safety of treatments. The study aimed to investigate: • How common symptoms associated with testosterone deciency are among men in the UK. • How aware men are of the symptoms and available treatments. • How many men reporting symptoms have received a formal diagnosis. • What barriers prevent men from seeking medical advice or treatment. 2. Methodology The researchers conducted a cross-sectional online survey of men living in the UK. • Participants: 973 adult men. • Age range: 18–86 years. • Survey: A 54-question questionnaire covering symptoms, awareness of testosterone deciency, treatment options and barriers to accessing healthcare. • Assessment tool: The quantitative Androgen Deciency in the Aging Male questionnaire (qADAM), which evaluates symptoms associated with testosterone deciency. The researchers also examined whether age and other demographic characteristics were associated with a greater likelihood of reporting symptoms. Importantly, the study assessed self-reported symptoms and awareness. It did not establish the prevalence of biochemically conrmed testosterone deciency through blood testing. 3. Key Findings A. Symptoms were common, but formal diagnoses were uncommon The study found a substantial gap between the number of men reporting symptoms associated with testosterone deciency and the number who had received a diagnosis. Authors: Vivian N. Liu, David Roy Huang, Aos Alaa, Benedict Hayhoe and Austen El-Osta Journal: BMJ Open, published 10 July 2025.
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