Evidence map›Paper›PMID 41200956›Full record

ArticleAndrology2026

Healthy Aging Men Do Not Suffer From Relevant Limitations of Their Reproductive Functions.

Simone Bier, Jann-Frederik Cremers, Phillip Schrage, Amelie Körtje, Claudia Krallmann, Sabine Kliesch, Jörg Gromoll, Sandra Laurentino, Michael Zitzmann

Abstract read
In one paragraph

Article in Andrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Simone BierDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Jann-Frederik CremersDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Phillip SchrageDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Amelie KörtjeDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Claudia KrallmannDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Sabine KlieschDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Jörg GromollDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Sandra LaurentinoDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.
Michael ZitzmannDepartment of Andrology, Centre of Reproductive Medicine and Andrology, University Clinic and University of Münster, Münster, Germany.

Funding

German Federal Ministry for Education and Research 01GR2303
6 · The paper itself

Abstract

backgroundWhile metabolic disorders are well-established contributors to testosterone decline and erectile dysfunction (ED), little is known about the natural progression of reproductive parameters in healthy aging men.

objectivesThis study aimed to evaluate longitudinal changes in reproductive parameters and sought to determine the influence of body mass index (BMI) and glycated hemoglobin (HbA1c) on these changes. PATIENTS AND

methodsA total of 197 healthy men (aged 18-84 years) were assessed at baseline (FAMe 1), with 117 participants returning for follow-up (FAMe 2) after approximately 6 years. All participants underwent a thorough andrological examination.

resultsTotal and free testosterone levels declined significantly over 6 years in men older than 25 years at baseline (p < 0.05). FSH levels increased significantly in men older than 35 years at FAMe 1 (p < 0.05), while LH and SHBG remained unchanged. Despite moderate declines, semen parameters remained mostly within physiological limits. Erectile function exhibited a moderate but progressive decline (p < 0.001). In men over 45 years, neither age (p = 0.13) nor testosterone (p = 0.52) influenced erectile function, while an increment of HbA1c levels was significantly associated with deteriorating erectile function (p = 0.002). Similarly, AMS scores significantly increased after age 45, which was strongly correlated with higher HbA1c levels (p = 0.001). DISCUSSION: While testosterone levels declined with aging, they remained within the normal range, suggesting that healthy men experience only apparently mild reproductive aging. Erectile function and hypogonadism-like symptoms were more strongly associated with glycemic control than with testosterone levels.

conclusionIn healthy men, reproductive and sexual aging occur gradually, with testosterone and semen parameters largely preserved over time. However, metabolic health, rather than testosterone, plays a key role in the progression of ED and hypogonadism-like symptoms, emphasizing the need for preventive metabolic interventions to maintain reproductive health.

Indexed as

AgingHealthy AgingReproductionTestosteroneAdolescentAdultAgedAged, 80 and overBody Mass IndexErectile DysfunctionFollicle Stimulating HormoneGlycated HemoglobinHumansLongitudinal StudiesLuteinizing HormoneMaleFollicle Stimulating HormoneGlycated Hemoglobinhemoglobin A1c protein, humanLuteinizing HormoneSex Hormone-Binding GlobulinTestosteroneerectile functionhypogonadismmale reproductive agingmetabolic healthsemen parameterstestosterone decline

Identifiers

PMID41200956
PMCPMC13432631

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.