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Testosterone is produced primarily by the testes in men, although it also can be produced by the adrenal glands and other sites including adipose tissue and bone. It is responsible for testes descent and reproductive tract development in the fetus, development of male secondary sex characteristics in puberty, and the production of sperm. Testosterone production in men begins in utero, rises sharply in puberty, and then declines with age (Pic. 2). Indeed, the Massachusetts Male Aging Study showed that total serum testosterone levels decline by 1.6% per year starting at age 40. Testosterone is also produced by the ovaries, the adrenal glands, and tissues such as adipose tissue and skin in women, although serum concentrations are almost 20-fold lower in pre-menopausal women compared to age-matched men. Interestingly, testosterone levels also decline with age in women. This age-dependent reduction in testosterone is not restricted to humans, as it is also seen in older male rats and mice (>20 months of age) in conjunction with a decline in fertility, although whether levels decline in aged female animals has not been investigated.

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