Despitehaving access to care, many men with androgen deficiency may not bereceiving treatment, according to a report released on May 26, 2008 inthe Archives of Internal Medicine, one of theJAMAArchives journals.

Lowerthan normal levels of male hormones, including testosterone, in thebody indicate a deficiency in androgens. Symptoms of androgendeficiency can include low libido, erectile dysfunction andosteoporosis, and victims might also suffer from sleep disturbance,depressed mood and tiredness. Knowledge about and access to care forthis condition have increased in recent years, according to thearticle, but the treatment patterns for androgen deficiency have notbeen well described in community-dwelling males in the United States.

Toinvestigate this, Susan A. Hall, Ph.D., of New England ResearchInstitutes, Watertown, Mass., and colleagues studied data collectedfrom 1,486 men in the Boston area between April 2002 and June 2005.They were tested to estimate the number of men are actually receivingtreatment for androgen deficiency, in the hopes of explaining whatvariance existed between treated and untreated men to understand thepotential barriers to health care.

Of the men, 97 met thecriteria for androgen deficiency. Of these, 86 were symptomatic anduntreated, while 11 were prescribed testosterone treatment. Thetreatment types varied: 1 was using a testosterone gel, 3 used atestosterone patch, 1 used testosterone cream, 1 used the injectableform of testosterone cypionate, and 5 used unspecified formulations oftreatment. The unspecified forms were self-reported as being inintervals defined in weeks, implying that they were likely alsoinjectable forms. If this is true, a total of 6 were using testosteroneinjection treatment.

According to the authors, the frequencyof treatment was heavily influenced by economic factors: Men withuntreated androgen deficiency were the most likely of thethree groups to have low socioeconomic status, to have no healthinsurance and to receive primary care in an emergency department orhospital outpatient clinic. However, men with androgen deficiency,with or without treatment, tended to visit the doctor and receiveregular care more often throughout the year. That is, per year, menwith untreated androgen deficiency averaged 15.1 visits, with treatedandrogen deficiency averaged 12 visits, while men without the conditionaveraged 6.7.

Theyconclude that this indicates that the ultimate reason for the lack oftreatment in the population was not access to medical care: Under ourassumptions, a large majority (87.8 percent) of 97 men in ourgroups with androgen deficiency were not receiving treatment despiteadequate access to care, they say. The reasons for this are unknownbut could be due to unrecognizedandrogen deficiency or unwillingness to prescribe testosteronetherapy.

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