Clinical use of androgenic steroids at a major medical center: who prescribes androgens and how well do they do it?

S F Cavanah, Stephen F. W. Cavanah, James M. Jacobson, J M Jacobson, Thomas McIntyre, T McIntyre
Journal of clinical pharmacology · 1993 · vol. 33(3) , pp. 253–258 · doi:10.1002/j.1552-4604.1993.tb03952.x · PMID:8463439 · W2053096266
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Analysis of androgen prescriptions at Wilford Hall USAF Medical Center found that while testosterone enanthate and danazol were commonly prescribed, pretreatment evaluations were often incomplete and empiric treatment for erectile dysfunction was frequent.

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Abstract

To assess prescribing practices for androgens at Wilford Hall USAF Medical Center, the authors analyzed prescriptions for all patients receiving therapy during a 12-month period (n = 201) and reviewed the available outpatient records not maintained elsewhere (n = 105). The most commonly prescribed androgens were testosterone enanthate (144/201; 56.7%), and danazol (52/201; 25.9%). Review of the available outpatient medical records of 73 male patients using testosterone enanthate showed a mean age of 59.5 years, mean frequency of injection of 20 days, mean duration of therapy of 3.5 years, and mean dose of 226 mg. Therapy was initiated by a urologist (34/73; 46.6%), an endocrinologist (33/73; 45.2%), or an internist (6.73; 8.2%). Indications for therapy based on pretreatment laboratory and historical data included hypergonadotropic hypogonadism (24/73; 32.9%), hypogonadotropic hypogonadism (23/73; 31.5%), unspecified hypogonadism (7/73; 9.6%), and empiric treatment of elderly men with erectile dysfunction without evidence of hypogonadism (9/73; 26%). Pretreatment prostate examinations as well as measurement of serum testosterone (66/73; 90.4%) and serum gonadotropins (52/73; 71.2%) were often not performed. The authors conclude that records of patients treated with androgens show: 1) Doses are appropriate; 2) Empiric treatment of erectile dysfunction in elderly men is common despite the associated risks; 3) Laboratory and physical evaluation before treatment is often incomplete; 4) There was no evidence of androgenic substance abuse in patients studied.

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MeSH descriptors

Drug Prescriptions Drug Utilization Testosterone Congeners Adolescent Adult Aged Danazol Danazol Female Hospital Bed Capacity, 500 and over Hospitals, Military Hospitals, Teaching Humans Male Medical Records Middle Aged Practice Patterns, Physicians' Testosterone Testosterone Testosterone Congeners

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