Androgen therapy: testing before prescribing and monitoring during therapy

To explore the extent to which biochemical testing is used to diagnose androgen deficiency before initiating treatment and to learn whether recommendations for clinical monitoring of men taking androgen therapy are being followed.

Population-based retrospective cohort study.

Winnipeg, Man.

A total of 902 men who filled at least 2 prescriptions for androgen therapy.

Whether men had had baseline prostate-specific antigen (PSA) and testosterone testing before initiation of therapy and whether men had been monitored during the first year of treatment.

Of the 902 men who filled first-time prescriptions during the study period, only 475 (52.7%) had ever had PSA or testosterone tests. Before starting therapy, 315 men (34.9%) had had PSA tests, and 152 men (16.9%) had had testosterone tests. Less than 1% of the entire sample had had 3 or more tests during the year following initiation of therapy.

Indications for androgen therapy in this population appear to be based on clinical symptoms rather than on demonstrated biochemical androgen deficiency. Recommendations for clinical monitoring of men taking androgen therapy are not followed consistently.