{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:06:18Z","timestamp":1784264778039,"version":"3.55.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Debate persists regarding the diagnosis of late-onset hypogonadism and the symptoms attributed to low testosterone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine cross-sectional and longitudinal associations between endogenous testosterone levels and hypogonadal symptoms in community-dwelling men, and to explore whether these associations vary by immunoassay method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed 657 men from the Vara\u2013Sk\u00f6vde cohort who provided blood samples at baseline (2002\u20132005) and follow-up (2012\u20132014), completing the Aging Male Symptom questionnaire at the second visit. Endogenous\n                      <jats:italic>total<\/jats:italic>\n                      testosterone was measured by two different immunoassays. Given the systematically elevated\n                      <jats:italic>total<\/jats:italic>\n                      testosterone concentrations observed at the second visit, we recalculated to compare appropriately between visits. Associations were evaluated with linear and ordinal logistic regression models. Multivariate regression models were performed in four models to account for potential confounding variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In cross-sectional analyses, men with low\n                      <jats:italic>total<\/jats:italic>\n                      testosterone had higher scores than those with normal testosterone concentration in the sexual domain (final model; Mean difference = 1.7; 95% CI: 0.4, 2.9; p = 0.01). No differences were observed between intermediate and normal testosterone categories. Moreover, while directly measured testosterone values at second visit yielded a lower prevalence of biochemical hypogonadism compared to recalculated\n                      <jats:italic>total<\/jats:italic>\n                      testosterone levels, the sexual symptom burden remained consistent. Testosterone levels at baseline were not associated with\n                      <jats:italic>total<\/jats:italic>\n                      AMS score in men after ten years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In cross-section, low endogenous\n                      <jats:italic>total<\/jats:italic>\n                      testosterone concentration was associated with higher sexual symptom burden in men. While measurement platforms showed numerical shifts in testosterone values, the clinical association with symptom burden remained consistent, with the modern assay identifying the most symptomatic individuals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1882696","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T04:24:05Z","timestamp":1784262245000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Testosterone levels and symptoms of hypogonadism in Swedish men: a prospective study from the Vara \u2013 Sk\u00f6vde cohort"],"prefix":"10.3389","volume":"17","author":[{"given":"Amar","family":"Osmancevic","sequence":"first","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Ottarsdottir","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Hellgren","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Lindblad","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Allison","sequence":"additional","affiliation":[{"name":"Division of Preventive Medicine, School of Medicine, UC San Diego","place":["San Diego, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penelope","family":"Trimpou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Spela","family":"Kokelj","sequence":"additional","affiliation":[{"name":"Sahlgrenska University Hospital\u2019s Research, Education, Development & Innovation Unit, Sahlgrenska University Hospital","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bledar","family":"Daka","sequence":"additional","affiliation":[{"name":"General Practice\/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg","place":["Gothenburg, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2007-1972","article-title":"Hypothalamic-pituitary-testicular axis disruptions in older men are differentially linked to age and modifiable risk factors: the European Male Aging 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