Gaps in Patient Knowledge About Risks and Benefits of Testosterone Replacement Therapy

To assess patient knowledge of the symptoms of testosterone deficiency, and the benefits and risks associated with testosterone replacement therapy (TRT).

An anonymous, 10-question multiple choice survey was administered to consecutive patients presenting for urologic evaluation at an academic medical center, from December 2015 to April 2016. The survey included questions about perceived symptoms of testosterone deficiency, perceived benefits and risks associated with TRT, whether respondents had a diagnosis of testosterone deficiency, and whether they were interested in receiving TRT.

The survey response rate was 88% (97/110). The median age group was 41-50 years. Although 43% of all respondents reported an interest in TRT, only half of them had a clinical diagnosis of hypogonadism. The most commonly reported symptoms of low testosterone were "low energy" (54%), "decreased libido" (51%), "weak erections" (52%), and "decreased strength" (42%). Of the perceived benefits of TRT, the most commonly reported were "improved sexual function" (54%), "increased energy" (53%), and "feeling better" (51%). Half of the respondents were unsure of the risks of TRT. Of the respondents, 16%, 10%, and 8% acknowledged the association between TRT and heart attack, TRT and stroke, and TRT and blood clots, respectively.

There is disproportionate knowledge about the benefits vs the risks associated with TRT among patients. Although 43% of the respondents were interested in receiving TRT, half of the respondents were unsure of the associated risks. These findings indicate an ongoing need for patient education regarding TRT.