Literature DB >> 25382540

Are we testing appropriately for low testosterone?: Characterization of tested men and compliance with current guidelines.

Rena D Malik1, Brittany Lapin, Chihsiung E Wang, Justin C Lakeman, Brian T Helfand.   

Abstract

INTRODUCTION: Direct-to-consumer ads for testosterone replacement therapies have significantly increased over the past several years. Subsequently, testing for low serum testosterone has correspondingly increased. AIMS: We sought to determine the testing behaviors of practitioners as well as the characteristics of men who are undergoing testing for low testosterone.
METHODS: Men aged 18-85 years were queried from the institutional electronic data warehouse from 2009 to 2012. Men were considered "tested" if their serum total testosterone level had been measured for any purpose. Tested men (TM) were compared with those not tested (NT). MAIN OUTCOME MEASURES: The frequency and timing of testing for low testosterone as well as patient demographics and clinical characteristics were compared between TM and NT using multivariable logistic regression models.
RESULTS: Of the 321,674 total men, 10,133 (3.2%) underwent testing with a serum total testosterone (mean age of 55.2 ± 14.1 years). The frequency of testing increased from 2.5% to 3.6% during the study period (P < 0.001). Multivariable analysis demonstrated that TM were significantly (P < 0.001) more likely to be Caucasian and have increased body mass index. In addition, TM were significantly more likely to have comorbid conditions including decreased libido (adjusted odds ratio [aOR] 10.0, 95% confidence interval [CI] 8.5, 11.7), infertility (aOR 4.8, 95% CI 3.6, 6.6), erectile dysfunction (aOR 3.6, 95% CI 3.4, 3.8), osteoporosis (aOR 3.3, 95% CI 2.8, 3.8), depression (aOR 1.7, 95% CI 1.6, 1.8), prostate cancer (aOR 1.7, 95% CI 1.5, 1.8), hypertension (aOR 1.3. 95% CI 1.2, 1.4), chronic obstructive pulmonary disease (aOR 1.2, 95% CI 1.0, 1.4), and benign prostatic hyperplasia (aOR 1.2, 95% CI 1.1, 1.2). Among TM, only 889 (9%) men underwent testing between 7 am and 12 pm.
CONCLUSIONS: The rate of testosterone testing is increasing with most testing practices directed toward a subset of men with comorbidities that are associated with hypogonadism. Compliance of physicians obtaining early morning serum testosterone levels is low. Further education of practitioners is required to appropriately test patients for hypogonadism.
© 2014 International Society for Sexual Medicine.

Entities:  

Keywords:  Diurnal Variation; Hypogonadism; Low Testosterone; Serum Total Testosterone Testing

Mesh:

Substances:

Year:  2014        PMID: 25382540     DOI: 10.1111/jsm.12730

Source DB:  PubMed          Journal:  J Sex Med        ISSN: 1743-6095            Impact factor:   3.802


  9 in total

1.  Environment-wide association study to comprehensively test and validate associations between nutrition and lifestyle factors and testosterone deficiency: NHANES 1988-1994 and 1999-2004.

Authors:  D S Lopez; W Wulaningsih; K K Tsilidis; J Baillargeon; S B Williams; R Urban; S Rohrmann
Journal:  Hormones (Athens)       Date:  2020-02-19       Impact factor: 2.885

2.  Association of Prudent, Western, and Alternate Healthy Eating Index (AHEI-2010) dietary patterns with serum testosterone and sex hormone binding globulin levels in men.

Authors:  David S Lopez; Lydia Liu; Stephanie A Smith-Warner; Konstantinos K Tsilidis; Carrie Daniel; Jacques Baillargeon; Sabine Rohrmann; Elizabeth A Platz; Edward Giovannucci
Journal:  Hormones (Athens)       Date:  2022-01-11       Impact factor: 3.419

3.  Association of the extent of therapy with prostate cancer in those receiving testosterone therapy in a US commercial insurance claims database.

Authors:  David S Lopez; Danmeng Huang; Konstantinos K Tsilidis; Mohit Khera; Stephen B Williams; Randall J Urban; Orestis A Panagiotou; Yong-Fang Kuo; Jacques Baillargeon; Albert Farias; Trudy Krause
Journal:  Clin Endocrinol (Oxf)       Date:  2019-10-07       Impact factor: 3.478

Review 4.  Testosterone replacement therapy and the heart: friend, foe or bystander?

Authors:  David S Lopez; Steven Canfield; Run Wang
Journal:  Transl Androl Urol       Date:  2016-12

5.  Approaches to male hypogonadism in primary care.

Authors:  Kristi L Lawrence; Felicia Stewart; Brandi M Larson
Journal:  Nurse Pract       Date:  2017-02-12

Review 6.  Emerging Evidences in the Long Standing Controversy Regarding Testosterone Replacement Therapy and Cardiovascular Events.

Authors:  Jonathan Clavell-Hernández; Run Wang
Journal:  World J Mens Health       Date:  2018-05       Impact factor: 5.400

Review 7.  The Optimal Indication for Testosterone Replacement Therapy in Late Onset Hypogonadism.

Authors:  Yu Seob Shin; Jong Kwan Park
Journal:  J Clin Med       Date:  2019-02-07       Impact factor: 4.241

Review 8.  Endogenous and exogenous testosterone and prostate cancer: decreased-, increased- or null-risk?

Authors:  David S Lopez; Shailesh Advani; Konstantinos K Tsilidis; Run Wang; Steven Canfield
Journal:  Transl Androl Urol       Date:  2017-06

9.  Sex, Energy, Well-Being and Low Testosterone: An Exploratory Survey of U.S. Men's Experiences on Prescription Testosterone.

Authors:  Alex A Straftis; Peter B Gray
Journal:  Int J Environ Res Public Health       Date:  2019-09-05       Impact factor: 3.390

  9 in total

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