Trends in Androgen Prescriptions From Military Treatment Facilities: 2007 to 2011.

INTRODUCTION: The role of testosterone in health and quality of life has become increasingly visible and overtly marketed to the public. Some evidence suggests that testosterone levels in men may be low because of a variety of reasons, including stress and environmental exposures. OBJECTIVE: This study examines trends in testosterone prescriptions dispensed by military treatment facilities (MTFs). METHODS: We examined data from the Department of Defense Pharmacy Data Transaction Service to determine the nature of androgen prescriptions dispensed through MTFs from 2007 through 2011. RESULTS: The number of androgen prescriptions increased more than two-fold across the military from 19,494 in 2007 to 45,270 in 2011. Most prescriptions (99%) were for men. Androgen prescription rates rose 23% per year from 2007 through 2011 (p < 0.001, CI 23-24%). The prescription rate for 35- to 44-year-olds increased more than any other age group, with annual increases averaging 33% (p < 0.001, CI 32-34%). CONCLUSION: The number of androgen prescriptions within MTFs rose significantly from 2007 through 2011. This is similar to rises in androgen prescriptions seen in civilian medical systems. Clinical indications for the sharp increase in testosterone prescriptions are unknown, and the indications for clinically appropriate testosterone replacement need further clarification.

People with gender dysphoria who self-prescribe cross-sex hormones: prevalence, sources, and side effects knowledge.

INTRODUCTION: There is a scarcity of research into the use of non-physician-sourced cross-sex hormones in the transgender population. However, when medication is not prescribed by health professionals, users' knowledge of such medication may be adversely affected. AIMS: This study aims to define the prevalence of Internet-sourced sex hormone use in a population attending for initial assessment at a gender identity clinic, to compare the prevalence between gender-dysphoric men and women, and to compare knowledge of cross-sex hormone side effects between users who source cross-sex hormones from medical doctors and those who source them elsewhere. METHODS: In the first part of the study, a cross-sectional design is used to measure the overall prevalence of sex hormone use among individuals referred to a gender clinic. The second part is a questionnaire survey aiming at measuring sex hormone knowledge among individuals referred to this clinic. MAIN OUTCOME MEASURES: Main outcome measures were (i) categorical data on the prevalence and source of cross-sex hormone use and (ii) knowledge of sex hormone side effects in a population referred to a gender clinic. RESULTS: Cross-sex hormone use was present in 23% of gender clinic referrals, of whom 70% sourced the hormones via the Internet. Trans men using testosterone had a sex hormone usage prevalence of 6%; one-third of users sourced it from the Internet. Trans women had a sex hormone usage prevalence of 32%; approximately 70% of users sourced hormones from the Internet. Cross-sex hormone users who sourced their hormones from physicians were more aware of side effects than those who used other sources to access hormones. CONCLUSION: One in four trans women self-prescribe cross-sex hormones before attending gender clinics, most commonly via the Internet. This practice is currently rare among trans men. Self-prescribing without medical advice leaves individuals without the knowledge required to minimize health risks.

U.S. testosterone shortage: call for information.

AIDS: There is a nationwide shortage of certain injectable testosterone products following FDA actions against Steris Laboratories Inc., a division of Schein Pharmaceuticals, Inc. The FDA seized large stocks of the drugs at Steris Laboratories and shut down manufacturing, alleging that the company had not followed the proper procedures for documenting quality assurance. A "Consent Decree of Condemnation and Permanent Injunction" has allowed the company to resume distribution of some of its products, but this does not include the testosterone products. Steris is the only U.S. manufacturer of some of the testosterone products and is also the supplier for other companies that market these products. Testosterone patches and some other testosterone products are available, but they are more expensive and may not be covered under some managed-care contracts.^ieng

Building your body to survive: the use of anabolic steroids for HIV therapy.

AIDS: The loss of lean body mass (LBM) that is commonly associated with wasting syndrome has been linked to death in HIV disease. Bioelectrical Impedance Analysis (BIA) is a simple, inexpensive and painless technique used to assess body composition. The test gives a good reading of body cell mass, fat mass, and body water, and can be used to detect loss of LBM when it first occurs. BIA is a useful tool in managing and preventing wasting. Other factors that influence LBM include testosterone levels and anabolic steroids. Anabolic steroids, synthetic analogs of testosterone, are a Class III regulated drug. The use of anabolic steroids is controversial, and abuse by athletes led to the drugs being banned for many uses. A list of approved steroids, their actions, and potential problems associated with their use is included. Another table rates the major steroids for their effectiveness in AIDS therapy.^ieng