Over the past decade testosterone therapy has become one of the top treatments in the United States for men suffering from low testosterone due to testicular damage, also known as classical primary or secondary hypogonadism. 

However, a new study by Baylor College of Medicine’s Dr. Mohit Khera shows that the majority of men being treated with testosterone do not meet the requirements for this treatment.

“Testosterone therapy is currently only indicated for men with classical primary or secondary hypogonadism,” said Khera, associate professor in urology at Baylor College of Medicine and lead author of the study. “The problem is that only 15 percent currently being treated for low testosterone meet this criteria.”

In other words, roughly 85 percent of men being treated with testosterone do not meet the true indications for treatment. “These 85 percent of men typically experience an improvement in their quality of life after initiating testosterone therapy, and up until now we have not been able to define the condition these men are suffering from,” he said.

The study finds that the majority of men being treated are not suffering from classical primary or secondary hypogonadism, but instead they suffer from adult onset hypogonadism (AOH).

AOH is a clinical and biochemical syndrome characterized by a deficiency in testosterone with signs and symptoms caused by a testicular and/or hypothalamic pituitary dysfunction. This syndrome is characterized by a low testosterone value and low or normal gonadotropins, a reproductive hormone.

“Historically these patients with low testosterone and signs and symptoms of low testosterone were told that they do not meet the classical definitions of the disease, and we have now defined the syndrome that these patients are suffering from,” Khera said.

AOH is commonly associated with chronic medical conditions such as diabetes, metabolic syndrome and obesity. 

“My hope for this study is that the insurance agencies and regulatory agencies will also recognize AOH as a true condition. This will give patients greater access and more affordable means to testosterone therapy,” said Khera. “These findings will offer patients deeper understanding of the true condition they are suffering from.”

This study appears in Mayo Clinic Proceedings

Others involved in this work include Gregory A. Broderick, Culley C. Carson III, Adrian S. Dobs, Martha M. Faraday, Irwin Goldstein, Lawrence S. Hakim, Wayne J.G. Hellstrom, Ravi Kacker, Tobias S. Kohler, Jesse N. Mills, Martin Miner, Hossein Sadeghi-Nejad, Allen D. Seftel, Ira D. Sharlip, Stephen J. Winters, and Arthur L. Burnett.