Diagnosing Low T Outside North America: Worldwide Patterns 2006-2015

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A study that raises a number of questions about methodology reports on the diagnosis and treatment of hypogonadism outside of the United States and Canada. About 731 physicians were interviewed in Europe, South Africa, Central and South America. They were questioned about:

  • Prescription of T or withholding T
  • Factors in the long-term use of T and the role of T formulations therein
  • Awareness of the wider spectrum of action of T (cardiovascular disease)
  • Reimbursement of T and its impact on (continued) use
  • Best strategies for information on T for physicians.

Total T was a key factor in identifying hypogonadism, but for >80% of physicians, clinical symptoms were weighed during diagnosis. Once diagnosed, >85% received T treatment, but the treatment compliance was problematic. Of these patients, 36% decided not to start or continue the treatment.
More hypogonadal men are treated than before, but ∼20% goes unidentified. Physicians have a greater awareness that T deficiency can be an element in cardiovascular and metabolic disease, but more education of physicians on diagnosis and treatment of hypogonadism are needed. Problems with reimbursement of T are barriers in the prescription of T and its use by patients.

"Diagnosing hypogonadism and treating decisions in different parts of the world: shifts in patterns between 2006 and 2015," The Aging Male, V20, Number 4, 15 August 2015, http://www.tandfonline.com/doi/full/10.3109/13685538.2015.1100601?src=recsys
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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