Testosterone replacement therapy for men increased in the U.S. and the U.K. between 2000 and 2011, but whereas supplementation rates quadrupled in the U.S. during that time, they rose just 30 percent in the U.K., according to a new study published in the Journal of Clinical Endocrinology & Metabolism.
One likely explanation for the drastically different rates of low-testosterone treatment in the U.S. compared to the U.K. is the prevalence of direct-to-consumer (DTC) advertising in the U.S.
DTC advertising has been legal in the U.S. since 1982, but few drug makers took that marketing approach due to requirements about disclosing safety information. In 1997, however, the U.S. government eased those restrictions, effectively making DTC marketing easy and legal for drug manufacturers. DTC advertising remains illegal in the U.K.
“Heavy direct-to-consumer marketing of newer testosterone formulations in the U.S. may have led to a much wider interest in testosterone levels and hypogonadism symptoms, resulting in wider testing of men with nonspecific symptoms but normal levels rather than targeted testing of symptomatic individuals,” the new study said.
The study also found that a higher rate of low testosterone levels detected in the U.K. indicates more precision in identifying patients who are more appropriate for testing there in contrast to the U.S. where advertising-generated demand for testosterone supplements may create testing on a more generalized population.
“Interestingly, the increased testing in the U.K. seems to be more targeted, identifying more individuals with reduced testosterone levels,” the researchers explained. On the other hand, “the U.S. seems to be testing more and more men with normal levels.”
The study’s authors also said that because there tend to be discrepancies in the testosterone levels in men on the lower end of the normal level, testosterone supplements should not be dispensed based on the results of just one test.
In 2007, 36 percent of U.S. men found to have low testosterone levels began taking testosterone supplements. That figure increased to 43 percent by 2011. In the U.K., only 10 percent of men with low testosterone levels started taking supplements, and that rate remained constant through 2011, the study found.