Adherence to Topical Testosterone Therapy in Primary and Secondary Hypogonadism

Low adherence to topical testosterone therapy has been linked to lowered total testosterone values and poor outcomes.

A retrospective study of males with primary or secondary hypogonadism reports that low adherence to topical testosterone therapy shows an “unmet need and scope for improved health outcomes in this population of men,” presented Michael Grabner, PhD, from HealthCore, Inc., at the the 26th American Association of Clinical Endocrinologists Annual Scientific Sessions & Clinical Congress.

Dr Grabner and coauthors of the study attempted to evaluate adherence to topical testosterone therapy in a real-world cohort of commercially insured males with primary or secondary hypogonadism, and to compare baseline features and follow-up outcomes between patients who were adherent vs non-adherent. 

Data of male patients aged ≥18 years who initiated topical testosterone therapy between January 1, 2006 and September 30, 2015 were obtained from the HealthCore Integrated Research Database. “Adherence to the initial topical testosterone therapy was defined as PDC [Proportion of Days Covered] ≥80% during 12 months of follow-up,” stated Dr Grabner. 

A total of 3,184 patients initiated on topical testosterone were identified, of which 538 (17%) patients were adherent and 2,646 (83%) were non-adherent. Patients who were adherent had a greater share of initial topical testosterone therapy prescriptions from endocrinologists vs. non-adherent patients (38% vs 31%), and a lesser share from primary care physicians (35% vs 44%). 

Study authors noted a lower presence of baseline comorbidity among adherent patients vs. non-adherent patients: coronary heart disease (9% vs13%), depression (24% vs 29%), hypertension (40% vs 49%), insomnia (20% vs 24%), and obesity (9% vs 15%; all <.05). 

More than half of the patient subgroup with available lab data had low testosterone levels at baseline (250 ng/dL). At follow-up, the adherent patient group showed a greater increase in testosterone levels vs the non-adherent patient group (+239 ng/dL vs 165 ng/dL; <.01). Though not statistically significant, adherence was associated with lower odds of fatigue, depression, insomnia, and osteoarthritis.

Findings from the study add to the data on suboptimal adherence to topical testosterone therapy among men with hypogonadism. “This research demonstrated that adherence is associated with greater improvement in total testosterone lab values and may be associated with lower likelihood of having certain comorbidities, thus future research should focus on ways to improve adherence among this patient population,” the authors concluded.

Visit Endocrinology Advisor‘s conference section for continuous coverage from AACE 2017

Related Articles


Grabner M, Hepp Z, Raval A, Khera M. Topical testosterone therapy adherence among males with primary or secondary hypogonadism. Abstract 925. Presented at: 26th American Association of Clinical Endocrinologists Annual Scientific Sessions & Clinical Congress; May 3-7, 2017; Austin, TX.

This article originally appeared on MPR