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Testing the boundaries: Self-medicated testosterone replacement and why it is practised.

Mair Underwood1, Katinka van de Ven2, Matthew Dunn3

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Summary
This summary is machine-generated.

Many individuals self-medicate testosterone replacement therapy (TRT) due to difficulties accessing healthcare, preferring it for cost and convenience. This challenges the view of all non-prescribed testosterone use as problematic abuse.

Keywords:
Anabolic-androgenic steroidsEnhancementImage and performance enhancing drugsOnline ethnographySelf-medicationTestosterone replacement therapyTherapy

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Area of Science:

  • Endocrinology
  • Sociology of Health and Illness
  • Drug Policy Analysis

Background:

  • Non-prescribed testosterone use is often deemed illegal 'enhancement' or 'doping'.
  • Emerging evidence suggests some non-prescribed testosterone use may be therapeutic self-medication.
  • Testosterone self-medication, particularly among image and performance-enhancing drug (IPED) users, remains under-explored.

Purpose of the Study:

  • To investigate how and why individuals self-medicate testosterone replacement therapy (TRT).
  • To analyze the implications of therapeutic self-medication for understanding non-prescribed testosterone use.
  • To examine the experiences of men using enhancement doses of testosterone and self-medicating TRT.

Main Methods:

  • A 4-year ethnographic study of online forums and social media groups used by IPED users.
  • Thematic analysis of data from 31 men, focusing on 26 who self-medicated TRT.
  • Application of Bacchi's problematization approach to policy analysis.

Main Results:

  • Self-medicated TRT closely mirrors medically supervised TRT.
  • Primary drivers for self-medication include healthcare access barriers (practitioner reluctance/inability to prescribe).
  • Other factors include preference for self-management due to cost, convenience, supply reliability, and perceived practitioner expertise gaps.

Conclusions:

  • Documents therapeutic testosterone use outside clinical settings, challenging the 'abuse' label for all illicit use.
  • Questions the enhancement/repair dichotomy in drug use discussions.
  • Suggests policy reform to improve access to medical testosterone treatment may address the core issue, rather than solely focusing on non-prescribed use.