Study shows testosterone being prescribed when not medically needed

UTMB study shows testosterone being prescribed when not medically needed
Jacques Baillargeon. Credit: University of Texas Medical Branch

A new study by the University of Texas Medical Branch found that 20 percent of men were prescribed testosterone despite having normal testosterone levels based on the Endocrine Society's guidelines. The study also found that 39 percent of new testosterone users did not have a prostate cancer screening during the year before treatment and 56 percent were not screened during the year after starting treatment.

The study comes at a time when there has been a dramatic increase in prescriptions in men over 40 within the past decade as they seek to increase muscle tone and sex drive. However, the long-term risks of this treatment are not well understood.

The Endocrine Society has formally recommended that testosterone therapy only be prescribed to men with low and no signs of prostate cancer.

The UTMB study of more than 61,000 men from across the nation is the first to survey how many men with normal testosterone levels begin testosterone therapy and rates of prostate cancer screening before and during the therapy.

The population-based study examined health insurance data from 61,474 men 40 years or older treated with testosterone between 2001 to 2010. It appears in the Feb. 26 issue of Public Health Reports.

The UTMB analyses also showed that 25 percent of men included in the study did not have their testosterone levels checked before receiving a prescription. Nearly half of these men did not have their levels checked during the first year of treatment.

"These findings show that there may not be a consensus among physicians regarding the definition of 'low testosterone,' said Jacques Baillargeon, UTMB professor of epidemiology in the department of Preventive Medicine and Community Health and lead author of the study. "It's possible that in some cases physicians judge that a patient's symptoms, such as fatigue and loss of muscle mass, merit testosterone therapy without clinically defined ."

The study also found that 39 percent of new testosterone users did not have a prostate cancer screening during the year before treatment and 56 percent were not screened during the year after starting .

Baillargeon said that the low rates of prostate were surprising because, according to Endocrine Society guidelines, screening is recommended for all men before starting .

Many testosterone users did not see a urologist or endocrinologist before or during treatment and thus were less likely to receive care based on Endocrine Society guidelines.

"These findings are very important from a medical and standpoint given the rapidly increasing number of men receiving testosterone in the U.S.," said Baillargeon. "Further research on the medical decision-making processes involved in monitoring and will be important, given our limited knowledge of the risks of this therapy."


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Mar 04, 2015
I wonder if this is happening due to Dr's concerns around the affect of environmental endocrine disruptor's? The vast majority of these seem to be oestrogen like chemicals which the world is awash in. Were is a study showing definitively the level of a man's T at a particular age? In how many? What nationalities? Does the minimum level take into account environmental oestrogens or just serum levels of E2? There is a lot of unanswered questions in relation to T in men.
For example why hasn't there been a study done of weight lifters. I've read were there T levels can be 3 or 4 times the level of a 25 year old. Obviously one side effect with them will be testicular shrinkage and sterility in extreme cases. But what of the other factors? With T at those levels you don't hear of them dropping dead on a daily basis.
If a 60 year old had the T of a 30 year old. Would the 60 year old be able to work like a 30 year old? Would increased T sharpen spatial memory, plasticity, or rationality?

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