Individual testosterone decline and future mortality risk in men

Eur J Endocrinol. 2018 Jan;178(1):123-130. doi: 10.1530/EJE-17-0280. Epub 2017 Oct 24.


Objective: Male aging is characterized by a decline in testosterone (TS) levels with a substantial variability between subjects. However, it is unclear whether differences in age-related changes in TS are associated with general health. We investigated associations between mortality and intra-individual changes in serum levels of total TS, SHBG, free TS and LH during a ten-year period with up to 18 years of registry follow-up.

Design: 1167 men aged 30-60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study and who had a follow-up examination ten years later (MONICA10) were included. From MONICA10, the men were followed up to 18 years (mean: 15.2 years) based on the information from national mortality registries via their unique personal ID numbers.

Methods: Cox proportional hazard models were used to investigate the association between intra-individual hormone changes and all-cause, CVD and cancer mortalities.

Results: A total of 421 men (36.1%) died during the follow-up period. Men with most pronounced decline in total TS (<10th percentile) had a higher all-cause mortality risk compared to men within the 10th to 90th percentile (hazard ratio (HR): 1.60; 95% confidence interval (CI): 1.08-2.36). No consistent associations were seen in cause-specific mortality analyses.

Conclusion: Our study showed that higher mortality rates were seen among the men who had the most pronounced age-related decline in TS, independent of their baseline TS levels.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging / physiology*
  • Cardiovascular Diseases / mortality
  • Cause of Death
  • Denmark / epidemiology
  • Humans
  • Life Style
  • Luteinizing Hormone / blood
  • Male
  • Middle Aged
  • Mortality / trends*
  • Neoplasms / mortality
  • Registries
  • Risk Factors
  • Sex Hormone-Binding Globulin / analysis
  • Testosterone / blood*
  • Testosterone / deficiency*


  • Sex Hormone-Binding Globulin
  • Testosterone
  • Luteinizing Hormone