NEW ORLEANS—Testosterone replacement therapy (TRT) is seldom prescribed to hypogonadal men, researchers reported at the American Urological Association annual meeting.

In a study of men who participated in a nationwide health screening program, a team led by Nelson N. Stone, MD, Professor of Urology and Radiation Oncology at Mount Sinai School of Medicine in New York, found that hypogonadism (HG)—defined as a testosterone level below 300 ng/dL—was present in 42.8% of subjects, yet TRT was used by only 3.9%. 

Men with erectile dysfunction (ED) had the highest reported use of TRT (6.2%). TRT was more commonly used in men older than 65 years and those with a body mass index (BMI) of 30 kg/m2 or higher. Lower mean testosterone levels were associated with older age, diets high in fat, sedentary lifestyle, diabetes, and higher BMI. TRT use did not differ in diabetic versus non-diabetic men.

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The study included 11,584 men from the general population who participated in Prostate Cancer Awareness Week in 2011 and 2012 and completed health assessments. Of these, 4,849 (41.9%) had their testosterone levels determined. The men had a mean age of 61.6 years and mean testosterone levels of 358.8 ng/dL.

The authors concluded that urologists involved in men’s health should be aware of the high prevalence of HG and consider the potential benefits of TRT, especially in men with a high BMI or diabetes, and those who consume a high-fat diet and engage in minimal exercise.