Diagnosing and treating testosterone deficiency in different parts of the world. Results from global market research

AIM: This study analysed variations between different regions of the world in diagnosing and treating testosterone (T) deficiency. METHODS: Physicians were interviewed in Germany, Spain and the United Kingdom, in Brazil, in Saudi Arabia and South Korea. Items in the survey: 1) reasons/motivation to use or not to use T; 2) what category of patients would not receive T on the basis of these concerns; 3) concerns about prostate pathology in the decision not to provide T treatment; 4) phosphodiesterase type 5 (PDE-5) inhibitors are efficacious, but T treatment makes a comeback. RESULTS: Between 5% and 10% of consulting patients suffered from T deficiency. The fear to induce prostate cancer appeared very powerful. About 68% of physicians associate the use of T more with risks than benefits, more so in Europe than elsewhere. As a result about 35% of hypogonadal men do not receive treatment. The PDE-5 inhibitors are very prominent in the treatment of erectile dysfunction. Of patients suffering from erectile dysfunction, 18% to 29% have T deficiency which is not always diagnosed and treated. CONCLUSION: World-wide physicians require more education on diagnosing T deficiency, on the role of T in erectile dysfunction and the relative safety of testosterone treatment.