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Dealing with Low Testosterone - Hypogonadism

67K views 184 replies 48 participants last post by  raven2000 
#1 · (Edited)
I have been hesistant to post this thread for some time. While dealing with the dying days of my marriage and then struggling with whether or not my symptoms and issues were a result of stress and coping with the divorce I wasn't sure if my problems were physiological or psychological. But ... testing has confirmed what I would never have suspected were it not once again, for discoveries I made here on this forum. So in that vein, I hope sharing my information will be useful to others.

The website below is a great one-stop resource for learning about all things testosterone. What it is, what it does, what the measurements mean, and methods of addressing and treating the issue of deficiency. Without getting into existential discussion, testosterone is the hormone produced in the testes that basically, defines male sexual characteristics, bone mass, muscle mass, and influences energy levels and feelings of well being.

Mens Hormonal Health

These are other threads on TAM addressing this question - that from a guy's perspective isn't going to be an enthusiastic conversation - but probably is a necessary one, especially if it is having a negative impact on your relationship.

Any man out there having a mid-life crisis?

Could it be low testosterone?

Low testosterone, how to deal

In my case, what I have found most troubling about the diagnosis, is wondering how long it has been an issue. I have shared previously that I was diagnosed with Attention Deficit Disorder in my thirties. I struggled tremendously through college and at times in the work environment with attention and fatigue issues. I took medication for over a decade to treat my inability to focus that led to prostate problems, and utterly crashed my libido, ability to achieve or maintain an erection, or to have an orgasm. Basically the side effects of the medication I was taking increased the symptoms of hypogonadism or low test. To me, the kicker, and hope is the possibility that my ADD symptoms will be resolved by testosterone therapy.

For the benefit of others, in considering low test as a possible issue, my symptoms are as follows:

- Erectile Dysfunction
- Decreased Libido, I still have desire but not that driving urge. And even with desire, my body won't cooperate.
- Decreased penile sensitivity
- Difficulty achieving orgasm, This has almost always been an issue for me. I have the opposite of premature ejaculation.
- Depression, I want to qualify this as feeling more like an emotional trough. I don't feel that it comes anywhere close to clinical depression, although depression still feels like the best word. I feel like there is a damper on my emotions, and at times my energy level is zero.
- Insomnia, I've had bouts of this throughout my adult life. I usually chalked it up to stress - even when there were no apparent stressors in place.
- Fatigue, I'm not talking about feeling a little tired or having a hard time staying alert through the afternoon, I'm talking about a really weird inability to take action in the morning. It's like this low waking state, where I'm aware, but my mind doesn't engage to say - 'time to get up'. I will literally think that I have been awake in bed for 10 minutes or so, and discover when I actually do get up that I had been laying there for close to an hour.
In the evening, between 5 and 8 pm I am exhausted as in want to go to sleep for the night tired, have nearly fallen asleep behind the wheel tired. Occasionally I do doze off and awake a few hours later.

The reason I feel that laying this stuff out there is important, is that so much of it can easily be categorized as other conditions - thus missing the correct one. My physician and urologist never posited the possibility of low testosterone. I asked them to do a screening based upon my symptoms after reading about the subject here, particularly based on contributions and exchanges with Simply Amorous.The screening is a simple blood test.

Testosterone generally begins to drop once a man is in his thirties, the presumption is that the drop is about 1% per year. In my case, my symptoms became far more pronounce approaching my mid-forties. What complicated things in my mind, was this also coincided with the timing of the end of my marriage and divorce. So, based upon the results of my blood screening, I am pursuing treatment on the physiological side. If testosterone therapy doesn't yield any results in terms of the sexual or emotional symptoms, I'll be looking at options on the psychological side.

Frankly, the symptoms and consequences of this condition are humiliating. They are demoralizing. If you feel like crap, it makes you feel crappier. If you are generally confident and upbeat, it's tough to maintain that outlook. All of a sudden the inability to perform one of the most definitive of male traits - becomes the center of anxiety, fear and disappointment - especially if you are trying to forge new intimate relationships. I do want to forge new intimate relationships, and I do want to be back to my confident, upbeat self. So, I have no plans to ignore or deny the issue hoping it will go away, I'm opting for treatment, and would encourage any man on the fence, to get screened and pursue treatment as well.

Treatment takes several forms:

- Pills (Generally considered least effective)
- Transdermal Gels, this is a gel rubbed into the skin where the hormone is then absorbed into the blood stream.
- Injections, intramuscular injections via syringe
- Subdermal Implant, this is the option I chose. The medication is pelletized and inserted beneath the skin where a steady dose of the medication is absorbed for up to 4 months.

My therapy will likely start in early January. Benefits if any, should likely start to appear by February, within 4 to 6 weeks.

I will certainly try to post experiences and progress in the interim, and with ongoing treatment. I'll be happy to answer any questions either on the open forum or via PM.
 
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#8 ·
Hi, thank you for sharing such personal information. I am sure that it will be a great help to men reading this forum as well as women who may recognise the symptoms you list.

All of the symptoms you have listed my husband had. At the time I just put it down to the stress, he has a high stress job and works long hours. I did try to talk to him about it but it always came back to stress of work. It could well be that he was just stressed and was checking out of our marriage, it is difficult to say. I suppose he will only find out for himself if he is now seeing someone else or does in the future. Thank you so much for sharing and I hope that your therapy is successful :)
 
#9 ·
Thanks for sharing this. I'm in my forties and noticed that I seemed to take forever to recover from workouts like before. And all my coworkers told me that I'm not as aggressive. And I seemed to worry about unfinished projects like I never did before. Same problems you mentioned with sleep. So, I had it checked. Turns out that it was slightly above average.

What this doctor didn't know was that it was checked when I was young, with hypertension, and found to be much higher. My doc thinks I was just used to the higher level. My point is that a shift even within the normal range can be felt.

Thing is, I don't think the doctor would've checked it if I hadn't demanded it. She wasn't the one who treated me when when I was younger. So I now take tribulus terrestris, an extract that is known to make the body produce more testosterone, and I heal from workouts like the old days.
 
#11 ·
What this doctor didn't know was that it was checked when I was young, with hypertension, and found to be much higher. My doc thinks I was just used to the higher level. My point is that a shift even within the normal range can be felt.
That is the thing about Test levels, if a man is HIGH and falls hundreds of points in a short time, even if his #s are within normal range (300ish to 1100 depending on the Lab), YOU will feel it & dramatically sometimes. The further the drop, the worse the symptoms.

Even some of these men need treatment but fail to get it from their Docs because their numbers fall above the 300 point. My husband was never tested when he was younger, so we have no baseline to go by. But I can attest -He was NEVER Aggressive or a Risk taker, all those things associated with High test, he has been & remained stable in mind / attitude / energy even desire, for the most part, even He was more tired than me when younger, so when we learned of his lower levels --ranging from 323 to 503 (being the highest of 9 tests), I pretty much came the conclusion he has always been a "Lower test" guy. The only reason I sent him to the Doc was my sex drive increased. If not for this, neither of us would have noticed a thing!

I was really stressed out about this whole thing when the Encronologist said his levels were typical of a 60 yr old man!! Thankfully, in one of my Testosterone books , it explained that some men are lower most of their lives, in these cases, a man like my husband will feel BETTER at a 350 level in comparison to a man who was a 700 level that suddenly drops to a 450 level, he may even need treatment -because of the drastic changes in his energy, mood, desire. For these men, they need to find a Doctor who will consider the symptoms MORE than the Lab result numbers. I talked to a few men online who had higher Lab #'s than my husbands (many were in the 400's ) & who were getting treatment & says it saved their life !

Anyone listening on here, if you suspect this could be a problem, make sure you get LAB results, not just a Nurse telling you "you are fine" -all your numbers came back normal" if you suspect Low Test. This happens way too often.


So I now take tribulus terrestris, an extract that is known to make the body produce more testosterone, and I heal from workouts like the old days.
I looked into this but decided against it- I can’t remember why, but there was a reason. I did buy him some TongKat Ali at one time, he took this for a few weeks, then one day his skin became REALLY irritated & he couldn’t stand my touch, that was the end of that experiment.
 
#10 ·
I sometimes felt I was rambling, like a broken record at times so often dragging my Husbands Testosterone levels into many of my posts, whether it be to explain his less than aggressive behavior to worrying about his future levels, but here it turned out a "good" thing, catching Deejo's ears, one of our most fine articulate contributors of all Good Men here at this forum.

LOVE your bravery in sharing your very personal story & I hope to hear more of your journey to health & "energy boosting" wellness. I know from much reading this hormone does a real job on us in our thoughts, our moods, aggressiveness, even confidence, even our sexual fantasies! Look out what awaits you -better have that woman ready!:D

Some Docs are so clueless, rarely do they consider Hormones.

Low Test is becoming more & more of an epidemic in this day & age. Much of this is probably due to other drugs interacting. With so many STATINS being handed out like candy - many do not realize these can further lower levels, not a good thing if you are "lower" to begin with (like my husband). I was posting all over the internet about this at one time in my worried state as my husband has high Cholesterol , not to mention Diabetes on his dad's side of the family -even though he is very thin. It causes quite the dilemma for us, knowing these meds can lower his levels even further! He is good for now, but I don't want to push it. So we cut his Cholesterol meds in half. Lab results are still good, within range thankfully. Not sure why Docs give you way more of a higher dosage than is necessary to keep your levels within normal range.

Statins effect on Test here >>> Sexual Side Effects of Statins

Even those who take Metforin for Diabetes should be aware, this can further lower Test. Some links here >> Metformin Lowers Testosterone How Much?
 
#14 ·
Low Test is becoming more & more of an epidemic in this day & age. Much of this is probably due to other drugs interacting. With so many STATINS being handed out like candy - many do not realize these can further lower levels, not a good thing if you are "lower" to begin with (like my husband). I was posting all over the internet about this at one time in my worried state as my husband has high Cholesterol , not to mention Diabetes on his dad's side of the family -even though he is very thin. It causes quite the dilemma for us, knowing these meds can lower his levels even further! He is good for now, but I don't want to push it. So we cut his Cholesterol meds in half. Lab results are still good, within range thankfully. Not sure why Docs give you way more of a higher dosage than is necessary to keep your levels within normal range. [/url]
I don't want to take this off thread, but the statin risk is a personal one for me. I've taken them since the early twenties. Doctors noticed extreme hypertension and lipids. Nothing difinitive, but testosterone and adrenaline were very high. My insurance forced me, after 15 years, to change to a generic lipid reduction statin based on a different statin. Not only did I lose all sex drive, but I experienced those muscle symptoms they discuss on every commercial's disclaimers.

Problem is, most guys are too ashamed to discuss it with their doctor. My new doc is really young, and she turned red as a beet on the third appointment when I finally brought it up. But, I figured she wouldn't be half as embarrassing as my wife's handling of the issue.
 
#12 ·
What an incredibly brave and honest post. And I imagine a rather helpful one to those of us who will follow in your path as time passes.


QUOTE=Deejo;215695]I have been hesistant to post this thread for some time. While dealing with the dying days of my marriage and then struggling with whether or not my symptoms and issues were a result of stress and coping with the divorce I wasn't sure if my problems were physiological or psychological. But ... testing has confirmed what I would never have suspected were it not once again, for discoveries I made here on this forum. So in that vein, I hope sharing my information will be useful to others.

The website below is a great one-stop resource for learning about all things testosterone. What it is, what it does, what the measurements mean, and methods of addressing and treating the issue of deficiency. Without getting into existential discussion, testosterone is the hormone produced in the testes that basically, defines male sexual characteristics, bone mass, muscle mass, and influences energy levels and feelings of well being.

Mens Hormonal Health

These are other threads on TAM addressing this question - that from a guy's perspective isn't going to be an enthusiastic conversation - but probably is a necessary one, especially if it is having a negative impact on your relationship.

Any man out there having a mid-life crisis?

Could it be low testosterone?

Low testosterone, how to deal

In my case, what I have found most troubling about the diagnosis, is wondering how long it has been an issue. I have shared previously that I was diagnosed with Attention Deficit Disorder in my thirties. I struggled tremendously through college and at times in the work environment with attention and fatigue issues. I took medication for over a decade to treat my inability to focus that led to prostate problems, and utterly crashed my libido, ability to achieve or maintain an erection, or to have an orgasm. Basically the side effects of the medication I was taking increased the symptoms of hypogonadism or low test. To me, the kicker, and hope is the possibility that my ADD symptoms will be resolved by testosterone therapy.

For the benefit of others, in considering low test as a possible issue, my symptoms are as follows:

- Erectile Dysfunction
- Decreased Libido, I still have desire but not that driving urge. And even with desire, my body won't cooperate.
- Decreased penile sensitivity
- Difficulty achieving orgasm, This has almost always been an issue for me. I have the opposite of premature ejaculation.
- Depression, I want to qualify this as feeling more like an emotional trough. I don't feel that it comes anywhere close to clinical depression, although depression still feels like the best word. I feel like there is a damper on my emotions, and at times my energy level is zero.
- Insomnia, I've had bouts of this throughout my adult life. I usually chalked it up to stress - even when there were no apparent stressors in place.
- Fatigue, I'm not talking about feeling a little tired or having a hard time staying alert through the afternoon, I'm talking about a really weird inability to take action in the morning. It's like this low waking state, where I'm aware, but my mind doesn't engage to say - 'time to get up'. I will literally think that I have been awake in bed for 10 minutes or so, and discover when I actually do get up that I had been laying there for close to an hour.
In the evening, between 5 and 8 pm I am exhausted as in want to go to sleep for the night tired, have nearly fallen asleep behind the wheel tired. Occasionally I do doze off and awake a few hours later.

The reason I feel that laying this stuff out there is important, is that so much of it can easily be categorized as other conditions - thus missing the correct one. My physician and urologist never posited the possibility of low testosterone. I asked them to do a screening based upon my symptoms after reading about the subject here, particularly based on contributions and exchanges with Simply Amorous.The screening is a simple blood test.

Testosterone generally begins to drop once a man is in his thirties, the presumption is that the drop is about 1% per year. In my case, my symptoms became far more pronounce approaching my mid-forties. What complicated things in my mind, was this also coincided with the timing of the end of my marriage and divorce. So, based upon the results of my blood screening, I am pursuing treatment on the physiological side. If testosterone therapy doesn't yield any results in terms of the sexual or emotional symptoms, I'll be looking at options on the psychological side.

Frankly, the symptoms and consequences of this condition are humiliating. They are demoralizing. If you feel like crap, it makes you feel crappier. If you are generally confident and upbeat, it's tough to maintain that outlook. All of a sudden the inability to perform one of the most definitive of male traits - becomes the center of anxiety, fear and disappointment - especially if you are trying to forge new intimate relationships. I do want to forge new intimate relationships, and I do want to be back to my confident, upbeat self. So, I have no plans to ignore or deny the issue hoping it will go away, I'm opting for treatment, and would encourage any man on the fence, to get screened and pursue treatment as well.

Treatment takes several forms:

- Pills (Generally considered least effective)
- Transdermal Gels, this is a gel rubbed into the skin where the hormone is then absorbed into the blood stream.
- Injections, intramuscular injections via syringe
- Subdermal Implant, this is the option I chose. The medication is pelletized and inserted beneath the skin where a steady dose of the medication is absorbed for up to 4 months.

My therapy will likely start in early January. Benefits if any, should likely start to appear by February, within 4 to 6 weeks.

I will certainly try to post experiences and progress in the interim, and with ongoing treatment. I'll be happy to answer any questions either on the open forum or via PM.[/QUOTE]
 
#15 ·
Just wanted to add -this is the book I have on my shelves that helped me see/understand that so called "normal" Test levels can mean very different things for different men - some being not so normal at all -- depending on their baseline youthful highs (which generally was never taken to know).

It explains that there is indeed a "gray zone" for some in the "normal" 300-500 level range. When dealing with these numbers, a GOOD Doctor will take "severity" of symptoms over numbers.

Page 173 explains this very well, similar to my attempt in my last post.

Amazon.com: The Testosterone Syndrome: The Critical Factor for Energy, Health, and Sexuality--Reversing the Male Menopause (9780871318589): Eugene Shippen, William Fryer: Books
 
#17 ·
Deejo, what a nightmare! I can see how it would be humiliating and the physical symptoms debilitating. Some woman is going to be very lucky to have you. I applaud the courage to post this. May your testimony be helpful to other men who are in your position.
 
#18 ·
Deejo,

Your post really hit home with me and I thank you for telling your story. I just had a vasectory about 3 months ago. For about a month after the procedure, everything felt normal. Then I started to notice that my erections started to be harder to come by. Also, they are not "self-sustaining". Before the procedure, I could just THINK about my wife and I was "at attention". Now, my thoughts are not enough. And, it's getting more difficult for me to have sexual thoughts where before it was natural. Also, I am no longer affected by visual stimulus either. My wife and I have to be engaged in physical contact for an erection to occur and even then it's hit or miss. This has been pretty debilitating for me. My wife initially thought that I simply lost interest and that's not the case. I now believe that I have low testosterone. I am setting up an appointment to see if this is the case. I had a suspicion and reading the links and your post makes me think that this is the case.

Anyway, thanks again for your post. I really appreciate you sharing what you are going through. And, if this is what I am going through as well, it helps me know I am not alone. Good luck.
 
#45 ·
Deejo,

Your post really hit home with me and I thank you for telling your story. I just had a vasectory about 3 months ago. For about a month after the procedure, everything felt normal. Then I started to notice that my erections started to be harder to come by. Also, they are not "self-sustaining". Before the procedure, I could just THINK about my wife and I was "at attention". Now, my thoughts are not enough. And, it's getting more difficult for me to have sexual thoughts where before it was natural. Also, I am no longer affected by visual stimulus either. My wife and I have to be engaged in physical contact for an erection to occur and even then it's hit or miss. This has been pretty debilitating for me. My wife initially thought that I simply lost interest and that's not the case. I now believe that I have low testosterone. I am setting up an appointment to see if this is the case. I had a suspicion and reading the links and your post makes me think that this is the case.
I would see about getting the vasectomy reversed as soon as possible. For some men vasectomy basically seems to neuter them.
 
#20 ·
Deejo,

You are right about this, for me a course of chemotherapy to treat an autoimmune disease caused my nails to thin out and my eyebrows to almost disappear. I suspected my T level was low, tests showed it had gone to 0.

For me the gel did not work well enough, my T level went up, but not high enough. I've been self injecting T every other Saturday for several years now and it has made a big difference in my quality of life, of course increased libido when combined with my stbxw's non-existent libido is leading to divorce, but the overall improvement in my spirits and existence is worth it.

FYI self injecting is easy, but I gave myself over a thousand daily injections of a painful medicine (not insulin) well before I injected T. I self inject because I didn't want to try to see the only endocrinologist in town who had a very full schedule. I'm starting to think the pellets would be a good idea, now that I'm in SF and retired it might be easier to see someone on a regular basis.

Later this week I'll post a detailed description of the injection procedure, much of it learned from an infusion nurse who helped me with my first shots. The only reason it is more complex than most meds (insulin, vaccines) is because T is very viscous and needs to be warmed to body temperature before filling the syringe and injecting. Needles, syringes and T from Walgreen's w/o insurance cost me $20 or less a month.
 
#21 ·
Deejo,

The only suggestion I would offer, based on my personal experience with low testosterone and the medication, is to start out with the gel. There is no sure way to tell how you will react and receive the medicine and in my case my doctor had to up my dosage twice before finally getting the correct amount dialed in. This process should be quicker than starting off with the implant which would likely take months before an adjustment could be made.

The implant or injections are likely the best long term options, but I suggest you don't commit until your dosage is correct!

Welcome to the road back to a sense of normalcy!
 
#22 ·
ThinkTooMuch, I appreciate the input. I was left with the impression that injections caused distinct peaks and valleys, did you find this to be the case?

Frost, I tried Testim for about 2 weeks, based on that experience primarily in terms of contact with my 2 young children, I wasn't comfortable using gel over the long term.

Apparently the pellets come in a series of 10, we will initially be implanting 8. Doc is shooting for a level of between 600 and 800, and would rather start low then end up high and have to come down.
 
#25 ·
I too am so happy about this post. My husband has been going through something for a few years now, which is as long as we have been married. :( I am CERTAIN it is lowT as we have received his results back and they are below normal by a longshot. He is in his 40's and has ZERO drive for sex, which is not "normal" as some might say. They have also tried to blame it on shift work but I know others that do the same job and have a normal sex life or drive.
They have discussed HRT for him but have said they are worried it will cause infertility? I thought testosterone replacement is what you used to help fertility?
I am very confused and would love to hear some good news. He was on the injections before but we did not see a big difference. We have discussed this and really in the last year have not been intimate. We have gone through it all, therapy, endocrinology, anxiety, an ultrasound of his testicles, an MRI to see the pituitary gland. It's like they know what it is but want him to avoid fixing it? Any help or advice would be much appreciated Deejo as it seems you are going through all of this before we are.
 
#26 ·
Inkpen -

My sympathies to you and your husband, I know that my life lost a lot of zest, my interest in sex went down when chemotherapy caused hypogonadism. These days I'm pretty vigorous and interested and 20 years older than your H.

As I wrote earlier I'm giving myself a shot every two weeks. It took a while for my interest and energy levels to go up, by "while" I mean many weeks, I can't recall exactly how many.

My understanding is testosterone replacement if done correctly will increase fertility along with interest. I looked at a few sites, googling hypogonadism and fertility, they confirmed my belief, of course I have long since learned to take all web posts with a large grain of salt, including this one - I'm not a doctor or other medical professional.

Please not routine overdose of muscle building steroids including T over a long period of time can and will effect fertility, gonads literally shrink, I think these are at levels higher than used for normally used for HRT. Your H will need monthly blood work to monitor not just T levels, but other associated factors. Quest labs takes 5 tubes of blood when I go in for routine tests of liver function and T levels.

From what I've read since Deejo posted, I think under skin implants would be your H's best route, if you are considering getting pregnant or able to conceive, please make sure he doesn't use a gel - its impact on a fetus can be enormous, it can also impact your health in a negative way.

You may want to see another dr, there is a possibility the current practice may worry about some of the side effects of increasing T levels and the office's liability.
 
#27 ·
You guys keep mentioning a range of figures for Testosterone levels. Is there really only ONE number that shows up on a Testosterone screening?

Had my blood drawn Tuesday, but have heard nothing back. Tempted to call and ask about my "number" - but kind of want to know what I'm asking for before I do.

And I now have a sleep study scheduled for next Tuesday.

Of course my problem could also be stress, medication side effects, poor eating habits, perhaps I've overdone the exercising instead of easing into it (but i don't think so), need to lose a few pounds, getting "old" (38?), poor sleeping environment (wife who is up late with bedroom tv on and a dog that likes to sleep on my feet), etc., etc.,

I bet when a Monk gets sick, its pretty easy to diagnose.
 
#34 ·
I had to push the doc to do mine last year, I accepted the "it's normal" result. I must say the symptoms are way too familliar to me, you may have figured out my puzzle. Monday when I see the doc. I am going to get that specific number and push this issue a bit.. Like was said in an earlyer post, may have made a difference in my marriage, well too late for that I suppose, but not late to rock another gal's world .. hahaha
 
#35 ·
In that case, viagra already can rock!
My husband's level is around 350, which is within the normal range and doctor refused to give him injection but some viagras. He's got 100mg per pill, and he cut each pill into 3-4 pieces because he doesn't need that strong.
It works pretty and saves money, you only spend few dollars per round.:)
 
#38 · (Edited)
Men’s testosterone levels dropping, study says

Nov. 4, 2006
Special to World Science

The past two decades have seen a “substantial” and unexplained decrease in American men’s testosterone levels, a study has found.

Testosterone is a potent “male” hormone produced chiefly by the testes, and chiefly responsible for the development of male sexual characteristics. The substance also strengthens muscle tone and bone mass, and promotes good health in men.

The downward trend seems to be “due to some undocumented historical or contemporary influence, health related or environmental,” wrote researchers with the New England Research Institutes in Watertown, Mass., in the study.

The findings appear in the early online edition of the Journal of Clinical Endocrinology and Metabolism.

Average levels of the hormone dropped by 1 percent a year, the researchers reported. While a man’s testosterone level typically falls steadily with age, the investigators found what they argued was a faster decline than could be attributed to aging alone.

They suggested that rising obesity rates and decline in smoking might partially explain the findings, since both factors are associated with lower testosterone levels. But these trends accounted for only a small percentage of the drop, they added.

The researchers said the study population was relatively limited, consisting of 1,532 men from the greater Boston area, and thus the results need to be confirmed by follow-up research.


Have seen an uptick of posts regarding lack of male sexual desire, and questions about T levels, so I thought this was worth posting.

Link to the full text of the report:
A Population-Level Decline in Serum Testosterone Levels in American Men
 
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