Many Men Starting Testosterone Treatment Needlessly

Low testosterone treatment being prescribed without thorough testing

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Testosterone levels naturally decrease as a man ages. Many men have been using testosterone therapy to combat these declining levels. A new study looked at the increase in testosterone therapy and the men using it.

This study showed that many American men may not have been sufficiently tested before starting testosterone therapy.

The researchers believe that many men with normal testosterone levels are receiving therapy needlessly.

"Discuss treatment options for low testosterone with a medical professional."

This study was authored by J. Bradley Layton, PhD, of the University of North Carolina at Chapel Hill, and colleagues.

These researchers analyzed records from Medicare insurance claims in the United States and general practitioner healthcare records from the United Kingdom during the period between 2000 and 2011.

The analysis looked at 1.1 million American men and 66,000 UK men who were tested for low testosterone between 2000 and 2011. Of those tested, the researchers identified 410,019 American men and 6,858 British men who were prescribed testosterone therapy during this period.

“Over the past decade, older and middle-aged men are increasingly being tested for low testosterone levels and being prescribed testosterone medications, particularly in the United States,” said Dr. Layton. “While direct-to-consumer advertising and the availability of convenient topical gels may be driving more men to seek treatment, our study suggests that many of those who start taking testosterone may not have a clear medical indication to do so.”

This study revealed that the number of men beginning testosterone therapy in the United States since 2000 has nearly quadrupled. Over the same period, the number of men starting testosterone therapy in the UK only increased by a third.

“In the United States, we saw a clear trend where more and more men being tested actually had normal testosterone levels and non-specific symptoms,” Dr. Layton said. “This is cause for concern as research examines potential risks associated with testosterone use."

The researchers noted that current guidelines suggest that testosterone therapy be prescribed for men who have a history of symptoms and whose doctor has no doubt the patient has low testosterone.

The researchers found that men in the United States often started testosterone therapy after a single testosterone test or when levels were considered normal.

This study listed hot flashes, loss of body hair and low libido as some of the symptoms commonly associated with low testosterone, but it cautioned that testosterone levels tend to naturally decline as men age — lower levels of the hormone do not necessarily mean that an individual has low testosterone.

The researchers said that too much testosterone may raise the risk of heart attack, stroke and even death.

This study was published January 9 in the Journal of Clinical Endocrinology & Metabolism.

The study was funded by the National Institute of Health’s National Institute on Aging.

Several of the authors disclosed financial ties with various companies, including Genentech and GlaxoSmithKline.

M. Alan Brookhart has served on advisory boards for Merck, Pfizer and Amgen for unrelated projects with honoraria either declined or paid to institution.

This study was funded by a grant from the US National Institute of Health, National Institute on Aging.

Review Date: 
January 9, 2014
Last Updated:
January 13, 2014