CHICAGO -- Few men prescribed testosterone therapy received guideline-concordant diagnostic testing for androgen deficiency, and some received therapy despite contraindications, a retrospective chart review indicated.
In a random sample of 200 male patients cared for at a single institution, only 12% underwent testing according to the Endocrine Society's recommendations. This included having two low morning testosterone levels followed by measuring LH and/or FSH, as well as having no contraindications to testosterone therapy. Low testosterone was defined as total testosterone below 300 ng/dL, free testosterone below 70 pg/mL, or low bioavailable testosterone between 5 a.m. and 10 a.m.
Nearly 40% of men who received testosterone had appropriate low morning testosterone level checks, LH, and/or FSH, but they had contraindications to treatment.
"This highlights quite a discrepancy in testosterone prescribing practice," said Sophia Sinha, MD, of the University of Michigan (UMich) in Ann Arbor at ENDO 2026, the annual meeting of the Endocrine Society.
Co-author Maria Papaleontiou, MD, also of UMich, added that the study findings "highlight opportunities to improve patient care and reduce inappropriate testosterone prescribing. Long-term, these findings can lead to quality-improvement efforts and clinical decision support tools that promote consistent, guideline-concordant testosterone prescribing."
