TRT Trends: 2003-2013

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We all know that TRT is prescribed far more often than it used to be. This study investigated trends in testosterone replacement therapy use among reproductive-age men. The researchers assessed changes in testosterone replacement therapy use and practice patterns among 18 to 45-year-old American men from 2003 to 2013 and compared them to older men.

  • This is a retrospective, cross-sectional analysis of men 18 to 45 and 56 to 64 years old who were enrolled in the Truven Health MarketScan® Commercial Claims Databases throughout each given calendar year from 2003 to 2013, including 5,094,868 men in 2013.
  • Trends in the yearly rates of testosterone replacement therapy use were calculated using Poisson regression. Among testosterone replacement therapy users, the Cochran-Armitage test was used to assess temporal trends in age, formulation type, semen analysis and serum testosterone level testing during the 12 months preceding the documented use of testosterone replacement therapy.


  • Between 2003 and 2013, there was a fourfold increase in the rate of testosterone use among 18 to 45-year-old men from 29.2/10,000 person-years to 118.1/10,000 person-years.
  • Among testosterone replacement therapy users, topical gel formulations were initially most used.
  • Injection use then doubled between 2009 and 2012 (23.5% and 46.2%, respectively) and surpassed topical gel use in 2013.
  • In men 56 to 64 years old there was a statistically significant threefold increase in testosterone replacement therapy use, which was significantly smaller than the fourfold increase in younger men.

"Trends in Testosterone Replacement Therapy Use from 2003 to 2013 among Reproductive-Age Men in the United States," Journal of Urology, 2017 April,