Prescriptions for testosterone therapy have increased significantly during the last 10 years, according to a study in the current issue of JAMA Internal Medicine conducted by researchers at the University of Texas Medical Branch.
About 50 percent of the men in the study who had received testosterone therapy had been diagnosed as having hypogonadism, a condition where a man is unable to produce the normal levels of testosterone.
But the study also found that, among new users of a prescription androgen product, about 25 percent did not have their testosterone levels tested before starting the treatment. In addition, it’s unclear what proportion of the 75 percent who were tested had a low level of testosterone.
Dr. Jacques Baillargeon, lead author of the study and an associate professor in preventive medicine and community health at UTMB, said that he believes this is the first national population-based study of testosterone-prescribing patterns.
Using data from one of the nation’s largest commercial health insurance populations, the researchers looked at more than 10 million men age 40 and over. They found that testosterone therapy increased more than threefold, from 0.81 percent in 2001 to 2.91 percent in 2011 in men over 40. By 2011, 2.29 percent of men in their 40s and 3.75 percent of men in their 60s were taking some form of testosterone therapy.
“This trend has been driven, in large part, by direct-to-consumer marketing campaigns that have targeted middle-aged men and the expansion of clinics specializing in the treatment of low testosterone — or ‘low-T centers,’” said Baillargeon. He noted that the development of new drugs and improved delivery mechanisms, particularly topical gels, likely have contributed to the increases. Of the four delivery methods, topical gels showed the highest increase of use.
The study is significant, he said, because there is conflicting data on the short and long-term risks of testosterone therapy.
The study’s other researchers include Dr. Randall Urban, Dr. Kenneth Ottenbacher, Karen Pierson and Dr. James Goodwin. The study was supported by grants from the National Institutes of Health.
HOUSTON, KTRK’s Medical Reporter Christi Myers recently reported — You’ve seen the ads for “low t” everywhere. You’ve heard about all the “low t” clinics. That blitz has helped create a spike in new prescriptions for testosterone. But some men who don’t have “low t” are falling for the hype, and that’s increasing their chances for serious illnesses.
Lots of men worry they have “low t.” David Cordova really does.
“She said I think you have a testosterone deficiency. I said, ‘Can’t happen to me being the machismo man that I want to be,'” he said.
At 56, he was facing osteoporosis. To reverse that, his doctor put him on testosterone shots. But first, he had a blood test to check his testosterone level. That’s not always the case.
“We see a substantial percentage of younger men, men in their 40s, who begin testosterone therapy without even really knowing if they need it,” said Dr. Jacques Baillargeon, who conducted the UTMB testosterone study.
His UTMB study found one in four men start taking testosterone without knowing if they even need it. And he says new prescritions for testosterone have increased 300 percent in the past decade, even more for younger men.
The problem is if a man takes testosterone and doesn’t need it, he may be exposing himself to health risks like an increased risk of prostate cancer, stroke or heart attack.
“We don’t know the long term risks for prostate cancer. There are a lot of studies that have conflicting results,” Dr. Baillargeon said.
UTMB is now conducting a study on the risk of heart attack and stroke among testosterone users. And other studies are looking at the prostate cancer risk.
Until they have better answers, Cordova is being careful.
“We’re playing it safe because every six months they are monitoring me,” Cordova said.
But he’s worried many young men don’t realize the risks.