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M. Livingston, R. Jones, A. Khan, A. Heald, PS-08-015 Screening for Hypogonadism in UK Primary Healthcare: How to do This Effectively, The Journal of Sexual Medicine, Volume 14, Issue Supplement_4a, April 2017, Page e136, https://doi.org/10.1016/j.jsxm.2017.03.010
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Extract
Objective
Testosterone levels are increasingly being checked in primary care as awareness of the risks of male hypogonadism grows. We looked at what tests are performed to screen for hypogonadism and to rule out secondary hypogonadism.
Methods
All participants attended GP practices in Cheshire, UK. Data search was performed using the clinical database EMIS®, the provider of the majority of GP operating systems in Cheshire.
Results
The anonymised records of 9,094 male patients aged 18–98 years living in Cheshire, UK, who had undergone a check of serum testosterone in the ten years up to March 3, 2016, were analysed. Overall screening rate was 4.3%. Of the 8,788 men with a testosterone result, 1,924 men (21.9%) had a total testosterone level <10 nmol/L. Just 689 of 8,788 men (7.8%) had a sex hormone binding globulin (SHBG) result, corresponding to 30.5% of those potentially hypogonadal. Estimated free testosterone was negatively associated with BMI (Spearman’s rho -0.2, p<0.001), as was total testosterone in the over 50s. Of the 1,924 potentially hypogonadal men with a serum testosterone <10 nmol/L, 588/1,924 (30.6%) had a check of serum prolactin. 46.3% of these had LH measured and 41.7% had FSH measured. Only 19.1% of 1,924 men with a hypogonadal total testosterone level were subsequently put on testosterone replacement.
