So-called “male menopause” –or lower testosterone levels on older men—afflicts upwards of 4 in 10 men over the age of 45, according to research published in the B.C. Medical Journal.

However, very few men with low testosterone levels are ever diagnosed by a doctor, the researchers note. Low testosterone levels can induce a number of serious health issues, including erectile dysfunction, heart disease and osteoporosis.

The scientists added, however, that the only viable treatment option –testosterone replacement therapy—is still unproven.

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