The aim of this study is to evaluate the clinical significance of the total and free testosterone in aging men. This study was carried out on 45 healthy men. They were divided into three groups, according to the age, each group contains 15 men. Group I: age ranged from 50-60 years. Group II: From 61-70 years and Group III: From 71-85 years. For each subject, history was taken and clinical examination, routine laboratory investigations: total and free testosterone levels, also total and free prostate specific antigen (PSA). Transrectal ultrasonography (TRUS) was done. Bone densitometry by ultrasonography also done. Our results revealed that, the mean values of the total and free testosterone levels were progressively decline with increasing age. The lowest levels of total and free testosterone were found in-group III, but these lowest levels were still at the accepted normal range. The mean values of the total and free PSA levels in the different three studied groups were progressively increased with aging men, but its levels were still within the normal range. There was positive correlation between the total and free levels of testosterone. Also positive correlation was found between the total and free PSA values. Additionally an inverse relationship was found between testosterone levels either total or free with PSA values. Erectile function declined significantly by age, the worst was group III with significant correlation with the level of total and free testosterone in the three studied groups. In this work the broadband ultrasound attenuation (BUA) in-group II was significantly lower than group I (p<0.001) but insignificant difference between group II and group III. Relative Risk Fracture (RRF) in-group II was significantly increased compared to group I (p>0.003), but insignificant difference between groups II and group III (p>0.998).T-score was significantly lower in group II and III compared to group I ,(p<0.001), (p<0.02)for both respectively. Z-score showed highly significant reduction in groups II and III compared to group I (p<0.000) for both of them. While, non-significant differences between group II and III regarding T and Z-score(p>0.38),(p>0.554)respectively. Correlation between free (FT) and total (TT) testosterone, with bone densitometry, there were positive correlation between (FT) versus BUA, T and Z-score. It was positively correlated between (TT) versus BUA and T-score only, while the correlation of both was negative with RRF.
We concluded that, total and free testosterone progressively decline with aging. It was associated with progressive increase in the level of total and free PSA. These findings were associated with progressive decline in erectile function. Bone mineral density decreased
gradually with increasing age, and increased incidence of bone fracture.