Note to our followers: Due to a lack of sufficient funding, HealthNewsReview.org will cease daily publication of new content at the end of 2018. Publisher Gary Schwitzer and other contributors may post new articles periodically. If you wish to donate, your gift might help keep the site available to the public for a few more years, by defraying costs of web hosting and maintenance. All of our 6,000+ published articles contain lessons to help people improve their critical thinking about health care. Read more about our change in status. And here's how to make a donation.
Read Original Story

Philadelphia Inquirer is clear about the underwhelming benefits of testosterone therapy in older men

Rating

5 Star

Major study finds testosterone therapy is no fountain of youth

Our Review Summary

Testosterone therapy has become increasingly popular for older men over the past two decades or so, but scientific evidence has lagged behind popular practice.

This story describes results of a group of coordinated trials with men over 64 years old. The story gives a detailed description of some recent findings, and provides quotes from both people who believe the results are useful, and others who say the study proves there is no real benefit to testosterone treatment. It also did a nice job navigating and clarifying the murky area between what the drug has been approved for and the wider/questionable broader uses promoted by its manufacturers and other proponents.

 

Why This Matters

Testosterone therapy is one among a number of popular treatments to minimize the effects of aging. With a whole range of anti-aging regimens available, it is important to weigh the pros and cons of health fads against the weight of scientific evidence. This story makes it clear that knowledge about many of the potential benefits of testosterone is still in flux, and other claims just don’t bear up under the weight of scientific scrutiny.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

Although this article mentioned that rub-on testosterone products are readily available, it did not explicitly mention the cost of those products, or compare them to existing, approved treatment for anemia and low bone density in men.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

While the ideal would be a story that reported numerical data about what was actually found–what the scope of potential benefits/harms were in the trial–we’ll nonetheless give this a satisfactory score. There’s little doubt about the take-home message from this paragraph in the story: “A year of testosterone treatment was no better than a placebo for memory and thinking, and it increased fatty plaque in coronary arteries, a risk factor for heart disease. The hormone helped anemia and low bone density in the minority of men with those conditions, which can be treated with other, proven therapies.”

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The author of this story makes possible harms of the therapy clear: testosterone therapy increased fatty plaque in coronary arteries, a risk factor for heart disease. It also talked about the possible risk of stroke in a subset of men.

Does the story seem to grasp the quality of the evidence?

Satisfactory

This story does a good job of informing readers about the quality of and limitations to evidence for this therapy. It also gets points for mentioning the size of the main trial.

Does the story commit disease-mongering?

Satisfactory

If anything this article is the opposite of disease mongering. It reports results of a study that was commissioned out of concern that testosterone is overprescribed to older men and that many men who use it either have normal testosterone levels have never been tested.

One minor concern is that the context/fact-checking is delivered subtly and may be missed on a quick read.

For example:

AbbVie, which donated its leading brand, Androgel, to the trials, said in a statement that the company is “committed to our patients and is proud of our continuous support of research that advances science for the benefit of hypogonadism patients.”

As explained elsewhere, hypogonadism occurs when the body doesn’t produce enough of the hormone due to disease, injury, or chemotherapy.  It’s the condition for which testosterone-replacement therapy is approved–not experimental use for mood, libido, low bone density, etc.

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The story does an exemplary job of citing credible, outside sources about the study. We did not detect any conflicts of interest that were overlooked.

Does the story compare the new approach with existing alternatives?

Not Applicable

This story takes a broad view, and looks at the evidence for using testosterone for a number of conditions. Given that, it would be tedious to try and discuss all the alternatives.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

It’s made clear that testosterone is available. It would have been helpful to clearly state that this requires a prescription, but this is a minor quibble.

Does the story establish the true novelty of the approach?

Satisfactory

Novelty in this story is not so much about the treatment itself, which the article states has been a research focus since about the year 2000. The novelty here resides in the scope and expense of these clinical trials. The story makes that clear.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not rely on a news release.

 

Total Score: 8 of 9 Satisfactory

Comments

We Welcome Comments. But please note: We will delete comments left by anyone who doesn’t leave an actual first and last name and an actual email address.

We will delete comments that include personal attacks, unfounded allegations, unverified facts, product pitches, or profanity. We will also end any thread of repetitive comments. Comments should primarily discuss the quality (or lack thereof) in journalism or other media messages about health and medicine. This is not intended to be a forum for definitive discussions about medicine or science. Nor is it a forum to share your personal story about a disease or treatment -- your comment must relate to media messages about health care. If your comment doesn't adhere to these policies, we won't post it. Questions? Please see more on our comments policy.