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By age 50-60, many men experience clinically significant testosterone deficiency, presenting as: Persistent fatigue and reduced motivation Loss of muscle mass and strength Increased body fat, particularly visceral (abdominal) fat Decreased libido and sexual function Mood changes including irritability and mild depression Reduced bone mineral density Growth Hormone Decline Growth hormone secretion declines approximately 14% per decade after age 30, a process termed somatopause (2)

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A systematic search was conducted across PubMed, Google Scholar, SCOPUS, MEDLINE, and EMBASE from inception to January 17, 2025, yielding over 1.3 million articles