Many men with low testosterone levels do not receive treatment
Written by Anna Sophia McKenney
Tuesday, 27 May 2008
The majority of men with androgen deficiency may not be
receiving treatment despite having sufficient access to care, according to a
report in the May 26 issue of Archives of Internal Medicine, one of the
JAMA/Archives journals. Androgen deficiency in men means the body
has lower than normal amounts of male hormones, including testosterone,
according to background information in the article. Although prescriptions for
testosterone therapy for aging men have increased in recent years, treatment
patterns for androgen deficiency are not clearly understood in
community-dwelling U.S. males.
Susan A. Hall, Ph.D., of New England
Research Institutes, Watertown, Mass., and colleagues examined data collected
from 1,486 Boston-area men (average age 46.4) from April 2002 to June 2005 to
estimate the number of men receiving treatment for androgen deficiency, to
explain how treated and untreated men varied in seeking care and to understand
potential barriers to health care. Specific symptoms of androgen deficiency
include low libido, erectile dysfunction and osteoporosis and less-specific
symptoms include sleep disturbance, depressed mood and tiredness.
A
total of 97 men met the criteria for having androgen deficiency. Eighty-six men
were symptomatic and untreated, and 11 were prescribed testosterone treatment.
"Men were using the following: testosterone gel (n=1), testosterone patch (n=3),
testosterone cream (n=1), testosterone cypionate [an injectable form of
testosterone] (n=1) or unspecified formulations of testosterone (n=5)," the
authors write. "All of the unspecified forms of testosterone used were
self-reported as administered in intervals defined in weeks, which suggests that
these were injectable formulations."
"Men with
untreated androgen deficiency were the most likely of the three groups to have
low socioeconomic status, to have no health insurance and to receive primary
care in an emergency department or hospital outpatient clinic," the authors
write. However, all men with treated and untreated androgen deficiency were more
likely to report receiving regular care than those without the condition and
reported visiting their doctor more often throughout the year (with averages of
15.1 visits for those with untreated androgen deficiency, 6.7 visits for those
without the condition and 12 visits for those with treated androgen deficiency).
"Under our assumptions, a large majority (87.8 percent) of 97
men in our groups with androgen deficiency were not receiving treatment despite
adequate access to care," the authors conclude. "The reasons for this are
unknown but could be due to unrecognized androgen deficiency or unwillingness to
prescribe testosterone therapy."
