Medicine
If the ubiquitous television advertisements are to be believed, there is an epidemic of low testosterone (or “low T” for short) sweeping America. Men of all ages have been instructed in these advertisements to “ask their doctor” if they have any one of a list of nonspecific symptoms that could be improved with testosterone therapy. Although hypogonadism is the only widely recognized indication for testosterone supplementation, recent research suggests that substantial numbers of men without testosterone deficiency are receiving prescriptions.
Concerns about excessive testosterone therapy led the Endocrine Society and the American Urological Association to recommend in the Choosing Wisely campaign that clinicians not prescribe it to men without biochemical evidence of testosterone deficiency, including men with erectile dysfunction and normal testosterone levels. In addition to having questionable benefits for these patients, supplementation is potentially harmful. Recent studies have linked testosterone therapy to an increased risk of cardiovascular events in men over age 65 and in younger men with heart disease.
The Endocrine Society recently recommended that physicians talk with patients about these potential risks and avoid prescribing testosterone to men without hypogonadism. In the meantime, the U.S. Food and Drug Administration is re-evaluating the risk of stroke, heart attack, and death associated with testosterone products. Given well-documented efforts of pharmaceutical companies to expand the market for testosterone therapy by ghostwriting articles for lay and scientific publications, physicians would be wise to steer clear of commercially-sponsored educational offerings and restrict prescriptions of testosterone to patients with FDA-approved indications.
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This post originally appeared on the AFP Community Blog.
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Medicine
Too much testosterone therapy
If the ubiquitous television advertisements are to be believed, there is an epidemic of low testosterone (or “low T” for short) sweeping America. Men of all ages have been instructed in these advertisements to “ask their doctor” if they have any one of a list of nonspecific symptoms that could be improved with testosterone therapy. Although hypogonadism is the only widely recognized indication for testosterone supplementation, recent research suggests that substantial numbers of men without testosterone deficiency are receiving prescriptions.
Concerns about excessive testosterone therapy led the Endocrine Society and the American Urological Association to recommend in the Choosing Wisely campaign that clinicians not prescribe it to men without biochemical evidence of testosterone deficiency, including men with erectile dysfunction and normal testosterone levels. In addition to having questionable benefits for these patients, supplementation is potentially harmful. Recent studies have linked testosterone therapy to an increased risk of cardiovascular events in men over age 65 and in younger men with heart disease.
The Endocrine Society recently recommended that physicians talk with patients about these potential risks and avoid prescribing testosterone to men without hypogonadism. In the meantime, the U.S. Food and Drug Administration is re-evaluating the risk of stroke, heart attack, and death associated with testosterone products. Given well-documented efforts of pharmaceutical companies to expand the market for testosterone therapy by ghostwriting articles for lay and scientific publications, physicians would be wise to steer clear of commercially-sponsored educational offerings and restrict prescriptions of testosterone to patients with FDA-approved indications.
**
This post originally appeared on the AFP Community Blog.
- Psa Screening: What Is The Value?
Two studies published in the New England Journal of Medicine on line on March 18, 2009 regarding the use of prostate-specific antigen (PSA) screening for prostate cancer have been getting a lot of coverage in the popular media, including NPR and the New...
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Data from the Centers for Disease Control and Prevention document a steady rise in diagnoses of attention deficit hyperactivity disorder (ADHD) since its first national survey in 1997. Since stimulant medications are widely considered to be first-line...
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