From the Guidelines
The average testosterone level in a 74-year-old male is typically between 300-500 ng/dL (nanograms per deciliter). This represents a natural decline from younger adult levels, which can range from 300-1000 ng/dL. Testosterone gradually decreases at a rate of about 1-2% per year after age 40, resulting in lower levels by the time men reach their 70s. This decline is a normal part of aging and is sometimes called andropause or male hypogonadism of aging. While this range is considered normal for this age group, individual levels can vary significantly based on overall health, genetics, medication use, and lifestyle factors. If a man experiences symptoms like fatigue, decreased libido, or mood changes along with low testosterone, medical evaluation may be warranted. Treatment decisions should be individualized rather than based solely on numerical values, as what constitutes a "low" level requiring intervention depends on both symptoms and clinical context, as suggested by the American College of Physicians 1.
Some key points to consider:
- The incidence of low testosterone in the United States is reported to be approximately 20% in men older than 60,30% in those older than 70, and 50% in those older than 80 years 1.
- No well-defined, universally accepted threshold of testosterone levels exists below which symptoms of androgen deficiency and adverse health outcomes occur 1.
- The role of testosterone treatment in managing age-related low testosterone is controversial, and the U.S. Food and Drug Administration (FDA) requires the pharmaceutical industry to label all testosterone medications to clearly state that their products are approved for use only in persons with low testosterone levels due to known causes 1.
It's essential to note that while these studies provide valuable insights, the evidence is not always consistent, and more research is needed to fully understand the effects of testosterone treatment in older men. However, based on the available evidence, the average testosterone level in a 74-year-old male is typically between 300-500 ng/dL, and treatment decisions should be individualized and based on both symptoms and clinical context.
From the Research
Testosterone Levels in Older Men
- The average testosterone level in a 74-year-old male is not directly stated in the provided studies, but we can look at the age-specific thresholds for total testosterone levels in normally ageing men from the Massachusetts Male Ageing Study 2.
- According to this study, the 2.5th percentile for total testosterone levels in men in their 70s is approximately 156 ng/dl, which can be used as a threshold for abnormally low total testosterone levels.
- It's essential to note that testosterone levels decline with age, and these thresholds are based on a population of normally ageing men.
- The study also provides the range of total testosterone levels for apparently healthy men in their 70s, which is 5.4-28.4 nm (156-818 ng/dl) 2.
Comparison with Other Age Groups
- For comparison, the average testosterone levels for younger men are higher, with age-specific middle tertile levels ranging from 409-558 ng/dl for men 20-24 years old to 350-473 ng/dl for men 40-44 years old 3.
- These values are significantly higher than the threshold for men in their 70s, highlighting the age-related decline in testosterone production.
Testosterone Replacement Therapy
- Testosterone replacement therapy (TRT) is a treatment option for men with low testosterone levels, aiming to improve symptoms and signs of testosterone deficiency 4.
- However, the decision to initiate TRT should be based on individual patient characteristics, and clinicians must consider the potential benefits and risks, especially in older men with a history of heart failure 4.