Testosterone prescribing in the population-a short social epidemiological analysis in Sweden

In recent years, there has been an increased interest for use of pharmaceutical testosterone among elderly men. However, it is still scarcely studied if this use is conditioned by socioeconomic factors in the general population of elderly men.

Using individual-level data from a population-based cohort of men aged 65-84 years in the County Scania, Sweden, we analysed testosterone use in 2006 in relation to demographic and socioeconomic factors by means of multiple logistic regression. We also analysed national data at the ecological level to investigate trends in prescribing between 2006 and 2014.

The prevalence of testosterone use in Sweden among 65- to 84-year-old men increased by 83%, from 3.3 per 1000 men in 2006 to 6.0 in 2014. Testosterone use was more than twice as common in men in the highest income quintile compared with those in the lowest (0.68% versus 0.25%, odds ratio 2.69 and 95% confidence interval 1.80-4.02). Besides in the high-income group, testosterone use was highest in 65- to 69-year-old men, divorced men and, specially, in men with a previous hospital diagnose of hypogonadism.

Our findings show socioeconomic inequities in prescription of testosterone. This is a short analysis based on limited data, but because information on this topic is scarce, our analysis adds a relevant piece of evidence and highlights the need for further research.