Four-Fold Increase in Testosterone Prescriptions from 2003 to 2013- More in Younger Men

[Nelson Vergel]

Trends in Testosterone Replacement Therapy Use Among Reproductive-Age US Men, 2003-2013

Abstract
Purpose
Although testosterone replacement therapy (TRT) use in the US has increased dramatically over the past decade, trends in TRT use among reproductive-aged men have not been investigated. We assessed changes in TRT use and practice patterns among 18-45-year-old US men from 2003-2013, and compared them to older men.

Materials and Methods
This is a retrospective, cross-sectional analysis of men ages 18-45 and 56-64 enrolled in the Truven Health MarketScan Commercial Claims Databases throughout each given calendar year from 2003-2013 (n=5,094,868 in 2013). Trends in the yearly rates of TRT use were calculated using Poisson regression. Among TRT users, Cochran-Armitage tests were used to assess temporal trends in age, formulation type, and semen analysis and serum testosterone level testing during the 12 months preceding documented use of TRT.

Results
Between 2003 and 2013, there was a 4-fold increase in the rate of testosterone use among 18-45-year-old men from 29.2 per 10,000 person-years to 118.1 per 10,000 person-years (p<.0001). Among TRT users, topical gel formulations were initially used most. Injection use then doubled between 2009 (23.5%) and 2012 (46.2%), and surpassed topical gel use in 2013. Men 56-64 saw a statistically significant 3-fold increase in TRT use (p<.0001), which was significantly smaller than the 4-fold increase seen in younger men (p<.0001).

Conclusions
In 2003-2013, TRT use increased 4-fold in men 18-45, compared to 3-fold in older men. This younger age group should be a focus for future studies due to effects on fertility and unknown long-term sequelae.

 

[johndoesmith]

I'd argue that the internet(and direct to consumer advertising of pharmaceuticals) is responsible for a lot of the younger guys starting TRT, and definitely a big role in the increase in use of injections from 2009 to 2013. That period of time is when smartphones gained popularity, and internet use became significantly more common.

 

[Nelson Vergel]

I'd argue that the internet(and direct to consumer advertising of pharmaceuticals) is responsible for a lot of the younger guys starting TRT, and definitely a big role in the increase in use of injections from 2009 to 2013. That period of time is when smartphones gained popularity, and internet use became significantly more common.

I agree. That and testosterone shut down caused by anabolic steroids.

 

[johndoesmith]

I agree. That and testosterone shut down caused by anabolic steroids.

Has there been an increase in anabolic steroid use you think in that time frame? I imagine so, due to the popularity of the internet.

 

[trt4me]

A lot of people from the 90s used steroids and at the same time weren't concerned or knowledgeable about what happens after they are stopped.
Very concerning that very young guys under 30 are having sexual problems.

 

[Vince Carter]

I feel like this fits in the "no shat", category. masters of the obvious.

 

[trt4me]

I feel like this fits in the "no shat", category. masters of the obvious.

For us, yes.
The general public don't realize what is happening on mass to the male reproductive / hormonal system.

 

[johndoesmith]

I feel like this fits in the "no shat", category. masters of the obvious.

Absolutely, but it's good to have concrete evidence as opposed to just thinking it's the case.

 

[PAUL-E]

I think the advertisement of low-T raised awareness also maybe environmental factors.

 

[Weasel]

I think environmental factors have caused the majority of the issues, The internet and advertising is what has brought it to light for most people.

 

[johndoesmith]

I think environmental factors have caused the majority of the issues, The internet and advertising is what has brought it to light for most people.

You hit the nail on the head.