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19 November 2012

Changes in the worldwide diagnosis and treatment of testosterone deficiency between 2006 and 2010

Diagnosing and treating testosterone deficiency in different parts of the world: changes between 2006 and 2010. Gooren LJ, Behre HM. The Aging Male 2012;15(1):22-27.

This physician-based survey investigated the diagnosis and treatment of testosterone deficiency (hypogonadism) in various parts of the world in 2010. The study, conducted in Germany, Spain, the United Kingdom, Brazil and Saudi Arabia between April and May 2010, involved 353 physicians (229 urologists, 84 endocrinologists and 40 primary care physicians) who were interviewed to address the following issues (1) the reasons to use/not use testosterone in patients who have testosterone deficiency (2) the role of safety and other concerns in the decision to not provide testosterone treatment and (3) to evaluate the actual use of testosterone preparations for the treatment of erectile dysfunction. The results of this survey were compared with a previous survey conducted in Germany, Spain, the United Kingdom, Brazil and South Korea by the same investigators in 2006 to determine if any significant changes in clinical practice have occurred over the last 4 years.

Key Points

  • The majority of physicians surveyed (82%) would regularly use laboratory measurements of total testosterone to diagnose testosterone deficiency
  • Physicians consider the main symptoms of testosterone deficiency to be erectile dysfunction, lack of libido, fatigue, loss of power, depression, weight gain and loss of hair/reduced body hair

    • There was an increased awareness among physicians of depression and weight gain as clinical symptoms of low testosterone
  • For 70% of the physicians surveyed, the severity of the symptoms experienced was considered a more significant reason to start testosterone treatment than the laboratory value of testosterone
  • In 2010, significantly more physicians expressed concern about the adverse effects of testosterone treatment compared with 2006 (78% vs 54%)

    • Eleven percent of patients eligible for testosterone therapy did not receive treatment due to these concerns
  • The proportion of patients diagnosed with erectile dysfunction who have testosterone deficiency ranged from 41% to 63% depending on the country

    • These patients were more likely in 2010 to be treated with phosphodiesterase type 5 (PDE5) inhibitor monotherapy or testosterone plus PDE5 inhibitors than in 2006.
Last updated: 2018
L.ZA.MKT.GM.10.2016.1381