Testosterone is responsible for the development of the male body from the androgynous embryo, which will otherwise develop into the female form. If the testosterone receptors in the fetus are not working, or insensitive to the hormone, the development of the normal features of the male body will be incomplete or abnormal, or an intersex human will grow. If the hormone doesn’t make its reappearance at the time of puberty, the male body will not develop secondary sexual characteristics such as a larger penis, beard and body hair, a deeper voice, and a male sexual drive. If the hormone doesn’t flow around a boy’s blood steam adequately; his musculature will fail to develop, as it should. Only the presence of testosterone in his blood will let him know of his maleness through spontaneous erections.

By the time a man reaches forty, this ranginess may well have vanished and spontaneous erections are but a distant memory. He may still be usable in sexual situations, but his erection will take longer to get hard, and will ejaculate more weakly, and his refractory period will be longer. He may secretly want hugs and cuddles more than sex, but he may be afraid say so.

Andropause may be diagnosed when there is a low level of testosterone in the blood, symptoms of testosterone deficiency, and improvement of those symptoms when testosterone replacement is taken.

As there are many potential causes of testosterone deficiency, it is important to determine the exact cause of testosterone deficiency and determine which therapy is appropriate.

Measuring your testosterone level

Testosterone can be measured by a simple blood test. However, it is important to measure the level in the morning, as the amount of testosterone in the blood varies throughout the day. Sometimes, low blood levels of testosterone can be found later in the day due to a natural daily rhythm.

Testosterone can be measured in one of three different ways: total testosterone, "free" testosterone or bioavailable testosterone. Unfortunately, each method can give somewhat different results which has led to some controversy. Total testosterone measures all of the testosterone in the blood sample. However, because some of this testosterone is not thought to be active due to its attachment to compounds in the blood that increase with age, total testosterone levels give a misleading result in older men.

Free or bioavailable testosterone levels provide a more accurate measurement of the true amount of active testosterone in an older man's body. Your personal physician will help you decide whether to have free or bioavailable testosterone measured.

Should you take testosterone?

The decision regarding whether or not to take testosterone is a personal decision that many men will have to make as they age. Studies done in the last 10 years on testosterone therapy have shown positive effects on men's sense of well-being, improved libido, increased muscle bulk and strength, improved bone density, and improved sexual function.  If you think you may be experiencing the symptoms of andropause, ask your physician to measure your morning-time level of free or bioavailable testosterone. Every man is unique. It is worthwhile to obtain additional information on andropause and to discuss the different aspects of therapy with your physician.