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Diagnosing and treating testosterone deficiency in different parts of the world. Results from global market research
Authors:Professor Louis J Gooren  Hermann M Behre  Farid Saad  Annika Frank  Sebastian Schwerdt
Institution:1. Endocrinology/Andrology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlandsljgooren@truemail.co.th;3. Andrology Unit, Department of Urology, Martin-Luther University, Halle, Germany;4. Bayer Schering Pharma AG, Corporate Strategic Marketing Male, Health Care, Berlin, Germany;5. Bayer Schering Pharma AG, Global Market Research, Berlin, Germany;6. Bayer Schering Pharma AG, European Business Unit Gynecology &7. Andrology, Berlin, Germany
Abstract:Aim. This study analysed variations between different regions of the world in diagnosing and treating testosterone (T) deficiency.

Methods. Physicians were interviewed in Germany, Spain and the United Kingdom, in Brazil, in Saudi Arabia and South Korea. Items in the survey: 1) reasons/motivation to use or not to use T; 2) what category of patients would not receive T on the basis of these concerns; 3) concerns about prostate pathology in the decision not to provide T treatment; 4) phosphodiesterase type 5 (PDE-5) inhibitors are efficacious, but T treatment makes a comeback.

Results. Between 5% and 10% of consulting patients suffered from T deficiency. The fear to induce prostate cancer appeared very powerful. About 68% of physicians associate the use of T more with risks than benefits, more so in Europe than elsewhere. As a result about 35% of hypogonadal men do not receive treatment. The PDE-5 inhibitors are very prominent in the treatment of erectile dysfunction. Of patients suffering from erectile dysfunction, 18% to 29% have T deficiency which is not always diagnosed and treated.

Conclusion. World-wide physicians require more education on diagnosing T deficiency, on the role of T in erectile dysfunction and the relative safety of testosterone treatment.
Keywords:Testosterone  prostate disease  phosphodiesterase inhibitor 5  geographic difference  treatment decision  physician education
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