title: Recent trends in testosterone testing, low testosterone levels, and testosterone treatment among Veterans.
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.
authors: University of Washington, Seattle, WA, USA.
authors: T J
authors: TJ
authors: Walsh
authors: M M
authors: MM
authors: Shores
authors: A E
authors: AE
authors: Fox
authors: K P
authors: KP
authors: Moore
authors: C W
authors: CW
authors: Forsberg
authors: C E
authors: CE
authors: Kinsey
authors: S R
authors: SR
authors: Heckbert
authors: S
authors: S
authors: Zeliadt
authors: M L
authors: ML
authors: Thompson
authors: N L
authors: NL
authors: Smith
authors: A M
authors: AM
authors: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020249:Hormone Replacement Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013739:Testosterone / Q000008:administration & dosage*; D014481:United States; D014728:Veterans
chemical_list: D013739:Testosterone
keywords: Veterans; testosterone; trends