As more men become aware of the bad news regarding the side effects of testosterone products, the sale of testosterone prescriptions has been falling significantly. The most dramatic decline took place between 2013 and 2016 in the wake of public warnings from the FDA that such products increase the risk of heart attack, stroke, and prostate cancer.
The demand for products to cure “Low T” increased by 500 percent between 2003 and 2013. According to research published in the Journal of the American Medical Association (JAMA), that demand fell by nearly half after the FDA warnings were issued. These findings are in line with a similar study by the Veterans Administration that showed a decline of 40% in testosterone prescriptions over the same time period.
The concept of testosterone replacement therapy dates back to the mid-19th Century, and was used judiciously by the medical profession for certain conditions. However, at the beginning of the 21st Century, pharmaceutical companies began engaging in aggressive direct-to-consumer marketing, targeting men whose low testosterone levels were a natural result of aging or whose sexual dysfunction could be attributed to tobacco and alcohol use or co-morbidities such obesity and diabetes. Nonetheless, the use of testosterone supplements tripled between 2001 and 2011. The majority of men who used such therapies had no real medical reason for doing so.
In 2013, a study came out in the JAMA linking the use of testosterone to elevated risk of heart attack and stroke. That report was followed up by a second study published the following year. Shortly thereafter, the FDA issued a safety advisory . Twelve months later, the FDA ordered pharmaceutical companies to add language to their labels specifying that testosterone replacement therapy (TRT) may be inappropriate for those whose levels are low due to the aging process.
There was confusion later when, in 2014, Jacques Baillargeon, PhD., whose background is in public health studies and preventive medicine, published a study in the Annals of Pharmacotherapy indicating no association between cardiovascular risk and TRT. Baillargeon is the lead author of the current study and has disclosed having “relevant relationships” with Androgel maker AbbVie as well as Auxilium, Endo and GlaxoSmithKline.
About the current fall in demand for TRT, Baillargeon says it represents the proverbial “swing of the pendulum” away from indiscriminate use and toward the proper indications. He notes that TRT still has legitimate purposes for some patients who suffer from conditions such as male hypogonadism and preventing osteoporosis as well as women who undergo gender reassignment surgery in order to become male.