Department of Endocrinology, Vrije Universiteit medical center, Amsterdam, the Netherlands.
Aging Male. 2012 Mar;15(1):22-7. doi: 10.3109/13685538.2011.650246. Epub 2012 Jan 30.
An analysis of variations in diagnosing and treating testosterone (T) deficiency between different regions of the world in 2006 was repeated in 2010.
Physicians were interviewed in Germany, Spain, the United Kingdom, Brazil and Saudi Arabia about (1) reasons to use/not to use T. (2) safety (prostate pathology) and other concerns in the decision not to provide T treatment. (3) the actual usage of T preparations for treatment of erectile dysfunction (ED).
More men were treated with T in 2010. ED and lack of libido (2006) but also depression and obesity (2010) were regarded as symptoms of T deficiency. For 70% of physicians, severity of complaints was more significant than the laboratory value of T to prescribe T, more so in Germany (96%) than in Spain and Saudi Arabia. Concerns about prostate disease remained strong and, therefore, 11% of eligible patients did not receive T. PDE-5 inhibitors are more often combined with T in 2010 for ED.
More appropriate studies and more education of physicians are needed on diagnosing T deficiency, on the role of T in ED and on the evidence-based relative safety of T treatment.
对 2006 年和 2010 年全球不同地区睾酮（T）缺乏症的诊断和治疗差异进行分析。
在德国、西班牙、英国、巴西和沙特阿拉伯，对医生进行了采访，内容包括：（1）使用/不使用 T 的原因；（2）决定不提供 T 治疗时的安全性（前列腺病理）和其他问题；（3）实际使用 T 制剂治疗勃起功能障碍（ED）的情况。
2010 年接受 T 治疗的男性人数有所增加。ED 和性欲减退（2006 年），以及抑郁和肥胖（2010 年）被认为是 T 缺乏症的症状。对于 70%的医生来说，开具 T 治疗的依据是症状的严重程度而非 T 的实验室值，德国（96%）比西班牙和沙特阿拉伯更重视症状。对前列腺疾病的担忧仍然强烈，因此，11%符合条件的患者未接受 T 治疗。2010 年，PDE-5 抑制剂与 T 联合治疗 ED 的情况更为常见。
需要对 T 缺乏症的诊断、T 在 ED 中的作用以及 T 治疗的循证相对安全性进行更多的研究和医生教育。
