Incidence, temporal trends, and socioeconomic aspects of male hypogonadism

Abstract

Abstract Little data exists on temporal changes in the incidence of definite hypogonadism and its correlation with socioeconomic status. We extracted data from the Maccabi Health Services computerized database between 2001-2017, which includes all electronic health records and laboratory data. The study included 4261 men with biochemically verified hypogonadism defined according to the European Male Study criteria. Male hypogonadism increased persistently with age in all the socioeconomic strata. 75% of the hypogonadal men had hypogonadotropic hypogonadism (HH). The overall incidence of hypogonadism increased 1.4-fold between the 2001-2009 and 2010-2017 periods, mainly due to an increase in HH. The temporal increase in hypogonadism occurred in all age groups of all socioeconomic strata but was notably more prominent in the >51 age group of the more affluent socioeconomic strata. BMI remained unchanged throughout the study period. The temporal increase in HH corresponds with previous observations of a temporal decrease in testosterone levels in men of a yet undetermined cause. Hypothetically, both could be linked to an underappreciated association between mental distress due to workplace demands and occupational burnout in specific occupations (i.e., high-tech, finance, medical) associated with more affluent populations, and reflected by decreased global happiness indices. This preliminary proposition deserves further investigation.