• linkedin
  • Increase Font
  • Sharebar

    Men too often receive T for ‘soft’ indications


    Rebecca Z. Sokol, MD, MPHRebecca Z. Sokol, MD, MPH

    To gain an endocrinologist’s perspective on current issues in testosterone therapy and hypogonadism, Urology Times interviewed Rebecca Z. Sokol MD, MPH. Dr. Sokol is professor of obstetrics and gynecology and medicine at the Keck School of Medicine of the University of Southern California, Los Angeles. She is currently president of the American Society for Reproductive Medicine. Views expressed are her own and do not represent the views or opinions of the ASRM.


    One of the recent issues concerning testosterone therapy is an assertion that it is being overprescribed. What is your opinion on this?

    I am concerned that testosterone is being overprescribed. It’s reflected in our statistics. In the United States, testosterone prescriptions have more than doubled in the last 6 years. The most recent statistic I was able to find was from 2011: 5.6 million prescriptions, and that doesn’t include all the Internet sites that sell testosterone without a prescription. You would not believe how easy it is to get testosterone compounds online.

    Related - Data fail to support concerns over T therapy, CV risk

    Canadian authors estimate that there’s been an increase in the use of testosterone of 300% between 1997 and 2012. I would also point out that the most recent estimate of sales of testosterone, which is from 2011, is $1.6 billion.


    Is there a possibility that those prescriptions are warranted?

    I try to be open minded about this. More men probably need prescriptions for testosterone than we realized 25 years ago. Do I think as many men taking testosterone actually need the testosterone they’re taking? I highly doubt that.


    You’ve been quoted as saying that you’re concerned about “the rampant use of testosterone replacement therapy for very soft indications.” Can you elaborate?

    When I talk about men with “soft” indications, I’m referring to guys who are fatigued, a little depressed, having a bit of a middle-age crisis, and just not feeling their usual, perky self. I think those men are probably prescribed testosterone often but do not truly have a low testosterone level. The Androgen Deficiency in the Aging Male (ADAM) questionnaire was devised to uncover the symptoms of hypogonadism. But fatigue, poor sense of well-being, and even diminished libido can be associated with a number of different things.


    Next: What Dr. Sokol considers to be low serum testosterone

    More on Testosterone

    Decision to use testosterone must be individualized

    FDA rejects petition for black box warning on T meds

    New study: No increased risk of MI with testosterone



    You must be signed in to leave a comment. Registering is fast and free!

    All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

    • No comments available