“Older men with low testosterone need treatment.”
A low testosterone result alone does not mean an older man needs treatment; symptoms and repeat morning tests must both confirm a real deficiency.
If you are an older man told your testosterone is low, you do not need to start treatment because of that number or your age. Treatment is worth discussing only if you have symptoms such as low sex drive and repeat morning tests confirm the low level.
If you have symptoms, ask for a repeat early-morning fasting testosterone test before deciding anything.
Safety note: Testosterone lowers sperm production, can raise blood pressure and red blood cell counts, and needs regular monitoring. It is not advised for men with some conditions, including untreated severe sleep apnea, a very high red blood cell count or a recent heart attack or stroke.
Talk to a healthcare professional if: you have lasting low sex drive, erection problems or other symptoms you think may be hormone-related. Ask for at least two early-morning fasting tests before any decision about treatment.
Major guidelines and the FDA agree that a low number alone is not a reason to treat: diagnosis needs symptoms plus repeat low morning tests, and low levels due to aging alone are not an approved use. The grain of truth is that older men with symptoms and confirmed low levels can benefit modestly, as a year-long placebo-controlled trial showed for sexual function.
A low testosterone result alone does not mean an older man needs treatment; symptoms and repeat morning tests must both confirm a real deficiency. In a trial of 790 men aged 65 and older with symptoms and low levels, a year of testosterone gel modestly improved sexual function and mood but did not improve energy.
Testosterone varies by time of day, illness, sleep, nutrition, medicines and laboratory method, so one result can mislead. The FDA keeps a limit in testosterone labeling for low levels due to aging, and the Endocrine Society says terms like "age-related" hypogonadism blur the line between treatable disease and normal aging. In 2025 the FDA removed the boxed warning about heart risk after a large safety trial, but added warnings about raised blood pressure for all testosterone products.
- Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2018;103(5):1715-1744. DOI: 10.1210/jc.2018-00229. PMID: 29562364
- Snyder PJ, Bhasin S, Cunningham GR, et al.; Testosterone Trials Investigators. Effects of testosterone treatment in older men. New England Journal of Medicine. 2016;374(7):611-624. DOI: 10.1056/NEJMoa1506119. PMID: 26886521. PMCID: PMC5209754
- U.S. Food and Drug Administration. FDA issues class-wide labeling changes for testosterone products. February 28, 2025
- Endocrine Society. Statement on Testosterone Replacement Therapy. 2026