Salivary testosterone levels and health status in men and women in the British general population: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)

Context: Salivary testosterone (Sal-T) measurement by LC-MS/MS resents the opportunity to examine health correlates of Sal-T in a large-scale population survey. Objective: To examine associations between Sal-T and health-related factors in men and women aged 18–74 years. Design & Setting: Morning saliva samples were obtained from participants in a cross-sectional probability-sample survey of the general British population (‘Natsal-3’). Self-reported health and lifestyle questions were administered as part of a wider sexual health interview. Participants: 1,599 men; 2,123 women. Methods: Sal-T was measured using LC-MS/MS; linear regression was used to examine associations between health factors and mean Sal-T. Results: In men, mean Sal-T was associated with a range of health factors after age-adjustment, showing a strong independent negative association with BMI. Men reporting cardiovascular disease or currently taking medication for depression had lower age-adjusted Sal-T, although there was no association with cardiovascular disease after adjustment for BMI. The decline in Sal-T with increasing age remained after adjustment for health-related factors. In women, Sal-T declined with increasing age, however there were no age-independent associations with health-related factors or specific heath conditions, with the exception of higher Sal-T in smokers. Conclusions: Sal-T levels were associated, independently of age, with a range of self-reported health markers, particularly BMI, in men but not women. The findings support the view that there is an age-related decline in Sal-T in men and women, which cannot be explained by an increase in ill-health. Our results demonstrate the potential of Sal-T as a convenient measure of tissue androgen exposure for population research