As men enter middle age, their bodies become progressively more fragile and prone to heart disease, high blood pressure, weight gain, decreased sexual performance, depression, and a variety of other problems. While it is debatable whether these problems are part of the “male menopause” caused by declining androgen levels, one thing is clear: men are generally reluctant to talk about their “midlife crisis” – usually about politics or sports, or even about their doctors and partners. Politics or sports, not even to his doctor or partner. They may not be as strong as they were when they were younger, but they are as silent and stubborn as they were when they were younger. Only a few physicians also ask if the patient has problems such as sexual dysfunction or depression. At the Endocrine Disorders Summit and Forum, physicians addressed the pressing question: What is the “normal” level of testosterone (testosterone is the most important androgen in the male body) for middle-aged men? Is it inevitable that men over the age of 50 will have a reduced sex drive? Studies have shown that testosterone reaches its maximum level between the ages of 20 and 30 and gradually declines with age, with blood testosterone levels likely to fall by 30-40% between the ages of 48 and 70. Diabetes, hyperlipidemia, hypertension, obesity, cardiovascular disease, environmental pollution, and poor lifestyle can further reduce testosterone levels. A large-scale clinical study in Japan showed that men aged 40-69 with type 2 diabetes had significantly lower testosterone levels than healthy men of the same age, and that insulin resistance and atherosclerosis were responsible for the lower testosterone levels. Since many middle-aged and older men have varying degrees of androgen deficiency, scholars have conducted numerous studies on testosterone supplementation replacement therapy and whether androgens promote physical and mental health in men. Testosterone, the most important androgen produced by the testes, maintains male paraphilias such as low voice tone, beard, throat knot, and body shape, and can help produce sperm, stimulate protein synthesis in reproductive organs and muscles, as well as promote bone growth, calcium and phosphorus deposition, and red blood cell production, and can affect a person’s mood, personality, behavior, and cognitive abilities (spatial ability, mathematical ability, etc.). Low testosterone levels can lead to sexual dysfunction, fatigue, depression, muscle atrophy, osteoporosis, and other consequences. While women’s sex hormone levels drop dramatically after menopause, middle-aged men’s sex hormone changes are relatively mild and vary widely among individuals. For example, a 65-year-old man’s testosterone level may drop to 30% of its original level, while some men’s testosterone levels do not drop significantly. Therefore, many experts believe that the term “male menopause” caused by low testosterone levels is inappropriate and should be called “age-related hypogonadism” or “late-onset hypogonadism. The term “age-related hypogonadism” or “delayed hypogonadism” is inappropriate. Researchers estimate that because most people with “age-related hypogonadism” are undiagnosed, only 5% of men with clinical symptoms due to testosterone deficiency are treated. In addition, there are 10-20 million impotence sufferers of all ages who are unaware of the possible causes of impotence: high blood pressure, hypertension, diabetes and tons of sleeping, sedative, hypertension and heart disease pills. The survey showed that the prevalence of “age-related hypogonadism” was 15% at age ≥40, 23% at age ≥50, 33% at age ≥60, and 54% at age ≥70. As mentioned above, middle-aged men rarely talk about their plight, and some simply believe that others will take care of them, and are less self-protective than women. Therefore the field of male androgen and physical and mental health needs to be explored in depth, and sex education is urgently needed. Some scholars have even suggested that since men know their blood lipid levels, they should also know their testosterone levels! Lower testosterone levels can cause a range of symptoms, and although these classic symptoms are not necessarily attributed exclusively to low testosterone they are also closely linked to it. A very sensitive early symptom is a loss of libido, in addition to fatigue, insomnia, difficulty concentrating, loss of drive, muscle wasting, and loss of bone density. It is sometimes difficult to define physiological and pathological symptoms. Therefore, in order to choose hormone replacement therapy, not only the corresponding symptoms must be present, but also the blood sex hormone level must be tested. In contrast, some elderly men have a mild decline in androgens that is physiological and does not cause clinical symptoms. Testosterone supplementation therapy can only be used when the patient has laboratory tests confirming testosterone deficiency and clinical symptoms of androgen deficiency.