Pharmacist Outreach can Highlight the Risks of Undiagnosed Testosterone Deficiency in Males

Pharmacist Outreach can Highlight the Risks of Undiagnosed Testosterone Deficiency in Males

Chronic Disease Caused by Undiagnosed Testosterone Deficiency in MalesEven in today’s world where television commercials broadcast remedies for sexual issues related to low testosterone, the topic is still highly personal and difficult for many men to discuss. Unfortunately, that means they don’t know that there’s more at stake than sexual dysfunction—low testosterone also puts them at risk for obesity and chronic disease.

Pharmacists who find ways to open communication about testosterone deficiency in men can educate these patients about the risks and their treatment options. It’s important to take advantage of the newly released recommendations that reinforce the benefits and safety of testosterone replacement therapy. They’re the perfect opportunity for proactive outreach and education.

Expert Recommendations Released July 2016

Low testosterone is estimated to affect 40 percent of men aged 45 or older, but here’s the number that’s critical: less than 5 percent of them are diagnosed and treated.1 While explanations about the lack of diagnoses are scarce, factors that impact the problem include unwillingness to discuss sexual dysfunction, generic symptoms like fatigue that are easily explained by lifestyle issues, and a clinical presentation that can vary widely. When it comes to treatment, years of debate over the safety of testosterone replacement therapy have significantly influenced decisions. That’s where the recently released recommendations may help.

The July 2016 Mayo Clinic Proceedings published a report from an international expert consensus conference on testosterone deficiency and its treatment.2 Eighteen participants with specialties in urology, endocrinology, internal medicine, diabetes, and scientific research reviewed the evidence to date on testosterone replacement therapy. They unanimously agreed on nine scientifically-sound fundamental guidelines.

One of their most important conclusions is that testosterone therapy (T therapy) does not increase the risk of prostate cancer or cardiovascular disease, which were the health concerns fueling restricted use of T therapy. In fact, a large body of research suggests that low testosterone actually increases the risk of cardiovascular disease.

Some of the resolutions simply defined low testosterone, but here’s a rundown of relevant points:

  • Evidence does not support restriction of T therapy only to men with known underlying etiology.
  • Symptoms of testosterone deficiency occur as a result of low levels of testosterone and may benefit from treatment even if there’s no underlying condition.
  • Testosterone therapy is effective and evidence-based.
  • Age-specific recommendations against T therapy in adult males are not supported by the scientific evidence.
  • There’s no testosterone concentration threshold that distinguishes those who will respond to treatment from those who won’t respond.
  • Evidence does not support increased risk of cardiovascular events or prostate cancer due to T therapy.
  • Evidence supports a major research initiative to explore potential benefits of T therapy for cardiometabolic diseases, including diabetes.

Chronic Complications Related to Low Testosterone

Men typically associate low testosterone with sexual dysfunction—and rightfully so—but this focus means they tend to overlook other symptoms and worse, most don’t know about the connection between hypogonadism and chronic disease. Complications related to low testosterone include:

  • Loss of sexual desire and erectile dysfunction
  • Weight gain and obesity
  • Loss of lean muscle mass and decreased muscle strength
  • Low bone mineral density and osteoporosis
  • Insulin resistance
  • Metabolic syndrome
  • Higher risk of rheumatoid arthritis, lupus, and other autoimmune diseases
  • Dyslipidemia
  • Gynecomastia
  • Infertility
  • Fatigue
  • Mood changes

Even though many sources say that low testosterone is not associated with mortality, an article published in Endocrinology and Metabolism in October 2010 reports that it’s an independent risk factor for all-cause and cardiovascular mortality.3 In fact, the July 2016 expert consensus report agrees, saying that mortality rates are reduced by half in men with testosterone deficiency who received T therapy.

Tips for Pharmacist Outreach to Educate About Low Testosterone

Since a majority of men don’t even know they may have low testosterone, your intervention is critical. And thanks to visibility in the community, pharmacists can reach out in ways that other health care professionals cannot. This effort doesn’t need to take a lot of time, yet the long-term health benefits for men are immeasurable. Outreach efforts like this also expand your influence and reinforce your value in the community—something that’s bound to help in the face of competition from mega pharmacy chains.

Here are a few ways to connect with men—and their partners—including those who may not be comfortable discussing their sexual health:

  • Take a non-sexual approach. You can’t go wrong with a generic approach that doesn’t ignore, but slightly side-steps sexuality. For example:
    • Advertise current news like the expert recommendations.
    • Concentrate on the chronic health complications associated with low testosterone.
    • Focus on men but don’t exclude women—they may see one of your posters and talk with their partner.
  • Put up posters. Posters can be as easy as printing a page from your computer. Grab attention by using bold type, a simple, easy-to-read message, and eye-popping color. Make it more professional by putting it into a frame. Always encourage them to connect by putting “Ask the Pharmacist” or “Talk With the Pharmacist” as the last line. Start with these poster ideas or let loose with your own creativity:
    • “Did you know that low testosterone puts you at greater risk for developing diabetes?”
    • “Gained weight lately? Low testosterone may be to blame. Ask the pharmacist.”
    • “Notice muscle loss? Low testosterone may be the culprit. Let’s talk—the pharmacist is available.”
    • “Men are at risk for osteoporosis too, and low testosterone may be the culprit.”
    • “Changes in your sex drive? Let’s talk about your testosterone.”
  • Use social media and your website to spread information and awareness.4 When circulating information via social media or your website it’s important that the content reach the widest possible audience. You can do this by providing thought leadership content in the form of authoritative, insightful blog posts or informative, engaging landing pages on your pharmacy website. Ideally, your content will become a resource for not only your own patients but also those of other pharmacists who are referred to the site for its valuable information, or even for those just searching the web for the most relevant information possible regarding their condition.

Promote Long-Term Health With Education About Low Testosterone

Over the years, women’s hormone-related health concerns have been in the spotlight, so now it’s time to turn some of that attention on men. It’s vital for them to know that they can develop similar health issues from an imbalance in testosterone. Pharmacists may well be the first—and possibly only—health professional to intervene and offer the education they need to live a long, healthy life.

Pharmaceutica North America provides prescription drug products, unit-dose and bulk active pharmaceutical ingredients and a variety of OTC supplements to promote health. Contact us today to talk about how we can support your pharmaceutical needs.

Show 4 footnotes

  1. “Testosterone Deficiency: Practical Guidelines for Diagnosis and Treatment,” November 2011, http://www.bcmj.org/articles/testosterone-deficiency-practical-guidelines-diagnosis-and-treatment
  2. “Fundamental Concepts Regarding Testosterone Deficiency and Treatment,” July 2016, http://www.mayoclinicproceedings.org/article/S0025-6196(16)30115-X/fulltext
  3. “Testosterone and the Metabolic Syndrome,” October 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474619/
  4. “Reaching Out to Patients Via Social Media,” December 2013, http://pharmacytoday.org/article/S1042-0991(15)31054-9/pdf
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