Low Testosterone Not Being Adequately Addressed

About 5% to 8% of older men have lower than normal levels of testosterone, which is known to be associated with a decline in many bodily functions. But addressing the problem is lagging behind our knowledge of its frequency. New England scientists have quantified the frequency of specific treatment in the community, and reported in the Archives of Internal Medicine.

Some 1,500 men living in the Boston area, average age 46, were examined for possible untreated androgen deficiency. There were 97 of them who met the criteria; 86 showed symptoms (low libido, erectile dysfunction, osteoporosis, sleep disturbance, depressed mood, or tiredness). The rest of them were already taking testosterone – gel, patch, cream, or injection – or an unspecified form of therapy.

Whether they were taking treatment was found to depend largely on economic factors. On the other hand, the men with androgen deficiency, with or without treatment, tended to visit the doctor more often during the year: an average of 15 visits a year, versus 6.7 visits for those without the deficiency.

These numbers indicate that a large majority (88%) of men with symptom-producing androgen deficiency were not receiving specific treatment in spite of quite frequent access to a physician (over one visit a month, on average). It seems to me that family physicians should be more aware of the possibility of androgen deficiency in older men with generalized symptoms. It, after all, readily treated (see the US National Guideline).