Testosterone Effects on Bone and Frailty

Inclusion Criteria: * Men over age 60 years who have sustained a femoral fracture in the preceding 3 years * Total testosterone levels below 375 ng/dl or bioavailable testosterone levels at least 1.5 SD lower than the young adult mean * Able to come or be brought to the University of Connecticut Health Center (UCHC) for outpatient visits Exclusion Criteria: * Prostate specific antigen level over 4.0 ng/dl or the history of prostate cancer * Disease of bone metabolism (i.e., Paget's disease, osteomalacia, hyperparathyroidism) * History of pituitary disease * History of sleep apnea * Consumption of more than 3 alcoholic drinks/day * Use of androgen, estrogen, or DHEA in the preceding year * Use of antiresorptive agents such as calcitonin or bisphosphonates * Metastatic or advanced cancer * Current chemotherapy or radiation treatment * Plans to move in the next three years * Advanced liver or renal disease such that the subjects is unlikely to complete the three year intervention * Hemaglobin \>16.5 g/dl * Bilateral hip replacement or repair