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. 2015 Mar;3(2):287-92.
doi: 10.1111/andr.12014. Epub 2015 Feb 13.

Recent trends in testosterone testing, low testosterone levels, and testosterone treatment among Veterans

T J Walsh  1 , M M Shores, A E Fox, K P Moore, C W Forsberg, C E Kinsey, S R Heckbert, S Zeliadt, M L Thompson, N L Smith, A M Matsumoto
Affiliations

Recent trends in testosterone testing, low testosterone levels, and testosterone treatment among Veterans

T J Walsh et al. Andrology. 2015 Mar.

Abstract

Low serum testosterone (T) is common and increasingly prevalent with increased age. Recent studies report an 'epidemic' of T prescribing and concern about unnecessary T treatment. We investigated the number of men tested for T, the prevalence of low serum T levels, and initiation of T treatment among those with low T levels in men treated at Veterans Affairs (VA) facilities in the Northwest US (VISN 20). We identified male Veterans aged 40-89 years and examined yearly proportions of men tested for T, found to have low T levels (total T < 280 ng/dL, free T < 34 pg/mL, or bioavailable T < 84 ng/dL), and subsequently treated with T from 2002 to 2011. We excluded men who had T treatment in the year prior and men with diagnoses of prostate or breast cancer. Treatment initiation was defined as the first prescription for T within a year following a low T test. From 2002 to 2011, the yearly population of eligible men in VISN 20 increased from 129 247 to 163 572. The proportion of men who had serum T tests increased from 3.2% in 2002 to 5.8% in 2011. Among the tested men, the percentage of men with low T levels increased from 35.0 to 47.3%. However, the proportion of men with low T levels who were given T treatment within a year decreased from 31.0 to 28.0%. Despite large increases in T testing, and detection of men with low T levels, there was a slight decrease in the proportion of men with low T levels who were treated with T. The decrease in T treatment during this time period contrasts with other studies and may be related to higher comorbidity in Veterans and/or VA formulary restrictions on the use of transdermal T formulations.

Keywords: Veterans; testosterone; trends.

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Figures

Figure 1.
Figure 1.
Total Testosterone Tests Performed and No. of Hypogonadal Men by Year
Figure 2.
Figure 2.
Percentage of Men Receiving Testosterone Tests and Percentage of Low T Tests by Year
See this image and copyright information in PMC

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