The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Global trends in testosterone prescribing, 2000–2011: expanding the spectrum of prescription drug misuse
Abstract
OBJECTIVE: To provide the first multinational survey of temporal trends in testosterone prescribing, given that anecdotal evidence indicates that it is increasing in some countries, including Australia. DESIGN: Sales data for all testosterone products were obtained for 41 countries for each year from 2000 to 2011. For each testosterone product type (injectable, implantable, oral, transdermal), units sold were converted into defined monthly doses per year, reflecting total testosterone prescribing per product. MAIN OUTCOME MEASURES: National testosterone prescribing rate overall and per product type on a per capita basis. RESULTS: For every region and 37 of 41 countries, there was a major and progressive increase in defined monthly doses per year per capita over the 11 years surveyed. In most countries, the increases were steeper for the last half of the survey period. The proportion of testosterone prescribing represented by transdermal testosterone products, a surrogate measure of prescribing for older men, increased even more than did the total usage of testosterone products. CONCLUSIONS: In the absence of any new indications, off-label testosterone prescribing has increased in most countries in 2000-2011, especially over the last half of the period. The increased testosterone prescribing appears to be primarily for older men and driven by clinical guidelines that endorse testosterone prescribing for age-related functional androgen deficiency (andropause). By eliminating the fundamental distinction between pathological and functional androgen deficiency, these guidelines tacitly promote increased testosterone prescribing, bypassing the requirement for high-quality clinical evidence of safety and efficacy and creating dramatic increases in prescription of testosterone products.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Prescription of T supplements has increased phenomenally during the past 2 decades, especially in the larger group of men suffering from functional hypogonadism [247].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [247]
In the citing paper
“the number of patients diagnosed and treated for hypogonadism over the past decade has increased significantly, with an exponential rise in prescribed T in many developed countries.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [7]
Citations
Cites
Bhasin, S., Cunningham, G. R., Hayes, F. J., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Montori, V. M. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2354 · Cited by 1,954
Identification of late-onset hypogonadism in middle-aged and elderly men
Wu, F. C. W., Tajar, A., Beynon, J. M., Pye, S. R., Silman, A. J., Finn, J. D., O'Neill, T. W., Bartfai, G., Casanueva, F. F., Forti, G., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0911101 · Cited by 1,544
Adverse Events Associated with Testosterone Administration
Basaria, S., Coviello, A. D., Travison, T. G., Storer, T. W., Farwell, W. R., Jette, A. M., Eder, R., Tennstedt, S., Ulloor, J., Zhang, A., et al. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1000485 · Cited by 1,494
Bhasin, S., Cunningham, G. R., Hayes, F. J., Matsumoto, A. M., Snyder, P. J., Swerdloff, R. S., & Montori, V. M. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-2847 · Cited by 965
Prenatal and postnatal prevalence of Klinefelter syndrome: a national registry study
Bojesen, A., Juul, S., & Gravholt, C. H. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021491 · Cited by 894
Prevalence of hypogonadism in males aged at least 45 years: the HIM study
MULLIGAN, T., FRICK, M. F., ZURAW, Q. C., STEMHAGEN, A., & MCWHIRTER, C. (2008) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2006.00992.x · Cited by 767
Araujo, A. B., O’Donnell, A. B., Brambilla, D. J., Simpson, W. B., Longcope, C., Matsumoto, A. M., & McKinlay, J. B. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031719 · Cited by 591
Xu, L., Freeman, G., Cowling, B. J., & Schooling, C. M. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-108 · Cited by 569
Wang, C., Nieschlag, E., Swerdloff, R. S., Behre, H. M., Hellstrom, W. J. G., Gooren, L. J., Kaufman, J., Legros, J. J., Lunenfeld, B., Morales, Á., et al. (2008) · Journal of Andrology · doi:10.2164/jandrol.108.006486 · Cited by 443
Trends in androgen prescribing in the United States, 2001 to 2011
Baillargeon, J., Urban, R. J., Ottenbacher, K. J., Pierson, K. S., & Goodwin, J. S. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.6895 · Cited by 336
Flagged first, then by citations
Research works printed but not linked: 1
- Braun SR, 2013, Promoting “low T”: a medical writer's perspective, JAMA Intern Med
Cited by
Sorted by citations
Items 201–252 of 252
Meston, C. M., & Stanton, A. M. (2017) · Psychopathology · doi:10.1002/9781394258949.ch13 · Cited by 2
Benefits and Risks of Testosterone Therapy in Men With Testosterone Deficiency
Traish, A. M., & Morgentaler, A. (2019) · Elsevier eBooks · doi:10.1016/b978-0-12-813197-8.00018-x · Cited by 2
Impact of Testosterone Deficiency and Testosterone Therapy on Men’s Health
Traish, A. M. (2025) · Springer eBooks · doi:10.1007/978-3-031-89650-7_13 · Cited by 1
Bonenti, B., Puljević, C., Ferris, J., Barratt, M. J., O’Connor, T., & Piatkowski, T. M. (2025) · Journal of Drug Issues · doi:10.1177/00220426251403911 · Cited by 1
Haltom, T. M., & Worthen, M. G. F. (2026) · American Journal of Men s Health · doi:10.1177/15579883261418805 · Cited by 1
Stress-associated testosterone suppression: central adaptation or hypogonadism?
Friedl, K. E., Nindl, B. C., & Potter, A. W. (2026) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgag181 · Cited by 2
Kim, C., Pop‐Busui, R., Braffett, B. H., Cleary, P. A., Bebu, I., Wessells, H., Orchard, T. J., & Sarma, A. V. (2015) · The Journal of Sexual Medicine · doi:10.1111/jsm.13029 · Cited by 1
Savvidou, S., Gagalis, A., Efstratiou, I., & Kalambakas, A. (2014) · Journal of Interdisciplinary Histopathology · doi:10.5455/jihp.20140305101625 · Cited by 1
Obesity-Associated Low Testosterone Levels
Basaria, S. S. (2015) · The Endocrine Society eBooks · doi:10.1210/mtp4.9781936704941.ch57 · Cited by 1
The “Choosing Wisely” initiative to reduce low value care: has endocrinology been wise enough?
Sood, A., & Aron, D. C. (2015) · Expert Review of Endocrinology & Metabolism · doi:10.1586/17446651.2016.1130619 · Cited by 1
Safety of androgen therapy in men with prostate cancer
Rajan, P., Tharakan, T., & Chen, R. (2022) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2022.101628 · Cited by 1
Testosterone therapy in prostate cancer: is it still a controversy?
Bart, A. S., Hoof, A. V., Badre-Hume, R., Selvarajah, J., Robillard, K., & Albala, D. M. (2022) · Current Opinion in Urology · doi:10.1097/mou.0000000000001039 · Cited by 1
Buriti (Mauritia Flexuosa) Pulp and Oil as an Adjuvant in Testosterone Replacement Therapy
Silva, R. P. M. (2018) · Global Journal of Endocrinological Metabolism · doi:10.31031/gjem.2018.02.000535 · Cited by 1
Goldman, A., & Kathrins, M. N. (2022) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2021.11.008 · Cited by 1
Iyer, R., & Handelsman, D. J. (2023) · Springer eBooks · doi:10.1007/978-3-031-31501-5_23 · Cited by 1
Self-citationInder, W. J., & Grossmann, M. (2023) · European Journal of Endocrinology · doi:10.1093/ejendo/lvad100 · Cited by 1
Tadrous, M., Martins, D., Lee, K., Knowles, S. R., Mamdani, M., Juurlink, D. N., & Gomes, T. (2016) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.2016.1167600
Undecanoate in Routine Clinical Practice
Middleton, T. L., Turner, L., Fennell, C., Savkovic, S., Jayadev, V., Conway, A., & Handelsman, D. J. (2015)
Self-citationHormonal Evaluation and Therapy of Erectile Dysfunction
Hockenberry, M. S., & Masson, P. (2016) · Springer eBooks · doi:10.1007/978-3-319-31587-4_7
Gianatti, E. (2016) · Minerva Access (University of Melbourne)
Iyer, R., & Handelsman, D. J. (2017) · Springer eBooks · doi:10.1007/978-3-319-46086-4_19
Self-citationObstructive sleep apnoea and sexual function in men
Melehan, K. L. (2014) · The Sydney eScholarship Repository (The University of Sydney)
Azoospermia after testosterone gel treatment
Korneyev, I. A., & Дзамболатович, З. Р. (2017) · Urology reports (St - Petersburg) · doi:10.17816/uroved7231-33
Fui, M. N. T., & Mark, A. (2017) · Minerva Access (University of Melbourne)
Ethics of Finitude: Nursing and the Palliative Approach
Skinner, E. (2018) · uO Research (University of Ottawa) · doi:10.20381/ruor-21562
Debunking Internet Myths: What Is the Best Approach?
Eschler, D. C., & Leffert, J. D. (2019) · Springer eBooks · doi:10.1007/978-3-030-22720-3_5
Testosterone Replacement Therapy: Playing Catch-up With Patients.
Sheahan, W. T., Martinez, S., & Golden, A. G. (2015) · Europe PMC (PubMed Central)
Kotler, J. (2018) · Digital Access to Scholarship at Harvard (DASH) (Harvard University)
Testosterone Use and Abuse : Methodological Aspects in Forensic Toxicology and Clinical Diagnostics
Lood, Y. (2021) · Linköping University medical dissertations · doi:10.3384/diss.diva-173146
Risks of Testosterone Treatment
Dobs, A. S., & Yalamanchi, S. (2022) · doi:10.1093/med/9780198870197.003.0490
Bublak, R. (2017) · ästhetische dermatologie & kosmetologie · doi:10.1007/s12634-017-5429-8
Hormone Replacement Therapy in Men
Pham, C. H., Wang, C., & Swerdloff, R. S. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99449-2
Sobo, E. J. (2018) · The International Encyclopedia of Anthropology · doi:10.1002/9781118924396.wbiea1617
The Usefulness of Metabolic Ratios in the Interpretation of Steroid Misuse
Brailsford, A. D. (2017) · Royal Society of Chemistry eBooks · doi:10.1039/9781782621577-00325
The Business Landscape of Men’s Health
Weinberger, J. M., & Mills, J. N. (2023) · Cambridge University Press eBooks · doi:10.1017/9781009197533.003
The Impact of Male Obesity on Sex Hormones
Moreira, E. C. N. D. G., Machado, D. A. J. F., Delfino, B. A., Matos, G. O. A., & Zaccarelli-Marino, M. A. (2023) · Journal of Obesity and Weight-loss Medication · doi:10.23937/2572-4010.1510048
The good, the bad, and the ugly: Correct, questionable, and misuse of testosterone
Huhtaniemi, I. T. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-13432-6.00022-8
Testosterontherapie: transdermale Androgene
Čeponis, J., Yuen, F., Swerdloff, R. S., & Wang, C. (2024) · Springer eBooks · doi:10.1007/978-3-031-65245-5_14
Missbrauch und Missbrauch von Testosteron
Iyer, R., & Handelsman, D. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-65245-5_23
Self-citationHormone replacement therapy, male
Wang, C., & Swerdloff, R. S. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13825-6.00263-6
Muir, C. A., Wittert, G., & Handelsman, D. J. (2025) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaf334
Self-citationHistory of Testosterone Therapy in Men with Testosterone Deficiency: 1939–2024
Traish, A. M. (2025) · Springer eBooks · doi:10.1007/978-3-031-89650-7_14
Testosterone Effects on the Prostate: Focusing on Benign Prostatic Hyperplasia
Grutman, A. J., Su, Z. T., & Herati, A. S. (2025) · Springer eBooks · doi:10.1007/978-3-031-96376-6_31 · Cited by 1
Testosterone Measurement, Use and Misuse
Handelsman, D. J. (2025) · Springer eBooks · doi:10.1007/978-3-031-96376-6_17
Self-citationDisease Mongering: Corporate Greed and the Creation of Disease
Lexchin, J., Fugh‐Berman, A., & Mintzes, B. J. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-26472-6.00033-4
Scaled Testosterone: A Novel Metric to Calibrate Serum Testosterone and SHBG in MenPreprint
Handelsman, D. J., Wittert, G., Yeap, B. B., Muir, C., PhD Leon Flicker, M. B. B. S., Fui, M. N. T., & Grossmann, M. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.05.23.727352
Self-citationCalculated free testosterone: rightful heir to the free thyroxine index?
Narinx, N., Antonio, L., Lapauw, B., Fiers, T., Kaufman, J., Wu, F. C. W., & Vanderschueren, D. (2026) · Trends in Endocrinology and Metabolism · doi:10.1016/j.tem.2026.06.009
O’Brolchain, A., McAndrew, K., Newman, W., Young, D., Zyl, D. V., Dissanyake, R., Ebrahimi, E., & Griffin, K. (2026) · Endocrine · doi:10.1007/s12020-026-04722-4
Hashimi, M. A., Ho, C. C. K., & Kadıoğlu, A. (2026) · Springer eBooks · doi:10.1007/978-3-032-29112-7_16
Pharmacoepidemiology of testosterone prescribing in Australia, 2010-2023
Gialouris, J. V., Hou, W., Lim, S., & Handelsman, D. J. (2026) · European Journal of Endocrinology · doi:10.1093/ejendo/lvag158
Self-citationAdolf, J., & Raykov, G. (2026) · Drug Testing and Analysis · doi:10.1002/dta.70159
Lood, Y., Jönsson, A. K., Ahlner, F., & Chermà, M. D. (2026) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2026.113410
Metadata
- Authors
- Handelsman, D. J.
- Affiliations
- The University of Sydney (AU)
- Corresponding author
- Handelsman, David J
- ORCID
- Handelsman, David J
- Venue
- Medical Journal of Australia
- Publisher
- AMPCo
- Published
- 2013-10
- Volume
- 199
- Issue
- 8
- Pages
- 548-551
- ISSN
- 0025-729X (ISSN-L)
- 1326-5377
- OpenAlex
- W2068541344
- Cited by
- 253
- References
- 34
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 15 · 2023: 14 · 2022: 19 · 2021: 14 · 2020: 18 · 2019: 12 · 2018: 26 · 2017: 32 · 2016: 21 · 2015: 30 · 2014: 22
- FWCI
- 19.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- The Medical Journal of Australia (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Nursing › Issues, ethics and legal aspects › Pharmaceutical industry and healthcare
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- prescription drug misuse, off-label drug use, andropause, transdermal testosterone, testosterone implants, clinical guidelines, older men
- MeSH terms
- Australia, Cross-Cultural Comparison, Forecasting, Health Surveys, Humans, Male, Practice Patterns, Physicians', Testosterone, Health Care Costs, Evidence-Based Medicine, Hormone Replacement Therapy, Andropause, Off-Label Use, Prescription Drug Misuse
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review