A survey of 2 000 men has found that nearly almost a quarter of those with low testosterone levels struggle with symptoms – and even buy supplements or change their diets – for five years before seeing a doctor, as experts warn against dismissing increasing fatigue and weight gain simply as signs of ageing.
The survey, a collaboration between Imperial College London and Menwell, a private provider of testosterone, found that 24% of men with low testosterone levels admitted to waiting five years before seeking medical help, while 85% waited a year.
The most reported symptoms of testosterone deficiency (TD) included decreased sports ability (35%), low libido (31%), low energy (30%), and reduced erections (27%).
Testosterone, the male sex hormone, not only affects libido but also affects mental health, bone and muscle mass, and fat storage, as well as red blood cell production.
Although testosterone deficiency can affect men of all ages, the hormone does start to naturally fall in men after 40.
It can have a major impact on quality of life and overall health, but the symptoms are often vague and misdiagnosed as depression, or dismissed as natural ageing, reports The Independent.
The survey revealed the delay in seeking treatment is particularly pronounced in men over 50, who were nearly twice as likely to postpone treatment, with 82% of them admitting they wouldn’t discuss testosterone issues with friends.
A lack of awareness about symptoms and treatments like TRT contributes to the delay in seeking help.
Sufferers often attempt self-management strategies, including increased exercise (66%), dietary adjustments (62%), supplement use (46%), and stress management (32%). However, these efforts often prove insufficient.
One sufferer spoke out about the stigma of taking testosterone but warned there was “a lot of misinformation online …and a lot of people trying to sell supplements that don’t work”.
“Whatever you do, do not order stuff online, that is not the answer,” he added.
Instead, he urged men to see a doctor and have a blood test to find the root cause of the problem, and then get treated.
Dr Austen El-Osta, principal investigator for the Self-Care Academic Research Unit (SCARU) at Imperial College London, said: “Testosterone deficiency remains an under-recognised and under-treated condition, in part due to the stigma surrounding men’s health and societal expectations of masculinity.
“Our research highlights the systemic barriers that delay diagnosis and treatment, often leaving men to struggle in silence.”
Study details
A cross-sectional survey of experiences and outcomes of using testosterone replacement therapy in UK men
Austen El-Osta, Vivian Liu, David Huang, et al.
Abstract
Background
Prevalence of late-onset testosterone deficiency (TD) ranges between 6–30% depending on diagnostic criteria. Recent data highlights various benefits of testosterone replacement therapy (TRT) including increased libido, mood, bone-mineral density and lean body mass. This study investigated the personal experiences of men with TD, including access to TRT.
Methods
Previous or current TRT users were recruited from private clinics' mailing lists, professional medical organisations and researchers' professional networks. Participants completed a 52-item structured questionnaire on Qualtrics addressing perceptions and experiences of TRT and low testosterone symptoms. Associations between demographics, duration of symptoms and effectiveness were assessed using logistic regressions.
Results
Among the 905 men on TD treatment, 86% delayed treatment for > 1 year, while 26% experienced symptoms for > 5 year before seeking care. Older men were 1.79 times more likely to delay treatment. The majority (86%) reported TRT as very effective, with longer-term users 2.6 times more likely to report TRT as very effective compared to recent starters. Primary motivations for seeking TRT included improving personal relationships (79%) and physical appearance (53%). Most (81%) relied on online sources for information; fewer (18%) felt comfortable discussing hormonal health with their peers. Patient expectations during medical consultations focussed on diagnosis (77%), treatment options (64%) and learning about potential side effects (51%). The commonest side effects were acne (24%), testicular shrinkage (24%) and nipple itchiness/gynaecomastia (19%). TRT users reported notable improvements in overall quality of life (75%), mental wellbeing (71%), self-esteem and self-confidence (69%) and appearance (61%).
Conclusions
A significant proportion of men > 50 year surveyed reported experiencing prolonged symptoms of TD prior to seeking care. There is a need for greater awareness and education regarding TD symptoms, including streamlining timely and equitable access to effective treatment options.
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