The extent of the clinical consequences of the relative hypoandrogenism of elderly men remains unclear. It seems likely that hypoandrogenism intervenes in some aspects of the clinical changes in aging men, but it is also evident that the androgen status is only one of many factors influencing the pace and clinical expression of aging in men. A crucial remaining question is the possible existence of threshold concentrations for androgen action in target tissues and their level in the elderly, whereby local activating and catabolic tissue metabolism of testosterone, variations of androgen receptor concentrations and the possibility of tissue-specific co-activators and co-repressors of the androgen receptor offer almost unlimited possibilities for local diversification and modulation of testosterone action.

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