title: Clinical use of androgenic steroids at a major medical center: who prescribes androgens and how well do they do it?
abstract: To assess prescribing practices for androgens at Wilford Hall USAF Medical Center, the authors analyzed prescriptions for all patients receiving therapy during a 12-month period (n = 201) and reviewed the available outpatient records not maintained elsewhere (n = 105). The most commonly prescribed androgens were testosterone enanthate (144/201; 56.7%), and danazol (52/201; 25.9%). Review of the available outpatient medical records of 73 male patients using testosterone enanthate showed a mean age of 59.5 years, mean frequency of injection of 20 days, mean duration of therapy of 3.5 years, and mean dose of 226 mg. Therapy was initiated by a urologist (34/73; 46.6%), an endocrinologist (33/73; 45.2%), or an internist (6.73; 8.2%). Indications for therapy based on pretreatment laboratory and historical data included hypergonadotropic hypogonadism (24/73; 32.9%), hypogonadotropic hypogonadism (23/73; 31.5%), unspecified hypogonadism (7/73; 9.6%), and empiric treatment of elderly men with erectile dysfunction without evidence of hypogonadism (9/73; 26%). Pretreatment prostate examinations as well as measurement of serum testosterone (66/73; 90.4%) and serum gonadotropins (52/73; 71.2%) were often not performed. The authors conclude that records of patients treated with androgens show: 1) Doses are appropriate; 2) Empiric treatment of erectile dysfunction in elderly men is common despite the associated risks; 3) Laboratory and physical evaluation before treatment is often incomplete; 4) There was no evidence of androgenic substance abuse in patients studied.
authors: Department of Medicine, Wilford Hall USAF Medical Center, Lackland AFB, San Antonio, TX.
authors: S F
authors: SF
authors: Cavanah
authors: J M
authors: JM
authors: Jacobson
authors: T
authors: T
authors: McIntyre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003613:Danazol / Q000627:therapeutic use; D011307:Drug Prescriptions; D004363:Drug Utilization; D005260:Female; D006746:Hospital Bed Capacity, 500 and over; D006772:Hospitals, Military; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D013739:Testosterone / Q000627:therapeutic use; D045165:Testosterone Congeners / Q000627:therapeutic use*; D013781:Texas
chemical_list: D045165:Testosterone Congeners; D013739:Testosterone; D003613:Danazol