Secular trends in testosterone- findings from a large state-mandate care provider.

Background: Several studies from the US and Europe have shown a population-level decline in serum testosterone in men from 1970's to early 2000's. However, to the best of our knowledge, no study examining population-level decline in testosterone has been published in more recent years. The study objective was therefore to examine secular trends in testosterone levels among Israeli men in the first and second decades of the twenty-first century, METHODS: All incident total testosterone performed between1/2006 and 3/2019 among 102,334 male members of a large health organization.

Results: A significant (p < 0.001) and prominent trend of age-independent decline in the testosterone levels was recorded during the study period for most age groups.

Conclusions: There was a highly significant age-independent decline in total testosterone in the first and second decades of the twenty-first century. The decline was unlikely to be explained by increasing rates of obesity.