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Gary A Wittert Freemasons Centre for Male Health and Wellbeing, South Australian Health and Medical Research Institute, and University of Adelaide, Adelaide, South Australia, Australia

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Mathis Grossmann Department of Medicine, The University of Melbourne and Department of Endocrinology Austin Health, Heidelberg, Australia

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Bu B Yeap Medical School, University of Western Australia, and Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia

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David J Handelsman ANZAC Research Institute, University of Sydney and Andrology Department, Concord Hospital, Sydney, New South Wales, Australia

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decrease in serum testosterone concentration in middle to older aged men is associated with a reduction serum SHBG with mid-normal serum LH and FSH and is characterised by an accumulation of visceral adipose tissue associated with insulin resistance

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