Recent media reports and countless TV ads are creating fear about testosterone use in men, leaving a trail of mistrust and misinformation. So where is all this hype coming from? A recently published article in the Journal of American Medical Association (“Association of Testosterone therapy with mortality, myocardial infarct and stroke in men with low testosterone.” Vigen et Al, JAMA 2013, 3;10-1829-36) alleged that testosterone use increased the risk of death, myocardial infarction and strokes in men. The problem lies in the fact that this study doesn’t even meet basic statistical criteria to be considered valid, and yet its findings are being widely reported as fact.
In actual fact, the study being quoted is so completely flawed it would be laughable if the impact of its misinformation weren’t so serious. Top medical experts from around the world have called the study’s entire design, data presentation and methodology into question (Death by Testosterone: We Think Not! Adbulmaged et al. J. Sex Med 2014, 11;624-629). On examination, the findings of the much-hyped study were deemed to be not only incorrect, but also misleading. More importantly, when the study’s statistical analysis was done properly, the testosterone arm was found to have a positive health impact. Bet you haven’t seen the media reporting that, have you?
So let’s take a look at the findings. The authors of the original study claimed that the testosterone group had a 25.7% rate of events (123 events/1223 patients) while the no testosterone group had a 19.9% (1587/7486 patients) event rate, concluding that the testosterone arm showed a 5.8% increase in negative cardiac events. It doesn’t take a rocket scientist to see that everyone involved in this study failed basic math. 123 events in 1223 patients equals 10.1%, NOT 25.7%, and 1587/7486 patients equals 21.2%. Based on the raw study data, the patients who used testosterone actually had a 50% lower rate of events compared to the placebo arm. Isn’t that interesting?
Decades of statistically significant studies with solid data supporting the benefits of testosterone therapy in men and women exist, yet people (and doctors!) rarely hear about them. Numerous studies show testosterone therapy has a positive impact on many metabolic parameters, including glucose metabolism, decreased heart attacks and strokes, etc. So where is the media when good, statistically valid studies come out supporting the benefits of testosterone therapy? Where is the media when the results of bad studies they’ve been reporting as gospel are debunked? Clearly, something is wrong.
Why are we being continually bombarded by misleading, sensationalist articles about hormone therapies along with a constant stream of ads from legal firms? The answer of course, is MONEY.
In these days of 24/7 news cycles, if it bleeds, it leads, and the more sensational, the better. Legal firms jump into the game by running ads on TV, urging people to call now because they “may be eligible for substantial compensation”. Quite simply, these ads are nothing but fishing expeditions designed to hook enough people to be able to file a class action suit against drug manufacturers. Typically, legal firms stand to gain the lion’s share of any potential payout, so each time another study with supposedly negative health implications is released, you’ll see a new crop of sensationalist ads designed to drum up new business (no matter if the study is flawed). But make no mistake: there are other factors in play. Testosterone replacement therapy can help prevent many serious health conditions that would normally be treated using expensive pharmaceuticals – the very medications developed by drug companies who have a vested interest in selling more drugs – so continued misinformation about hormone therapy is nothing but good news for them. Follow the money and you will find the truth.