Experts warn of risks from private testosterone prescribing — News-Medical
Experts at The BMJ have warned about the risks of the rapid spread of private testosterone prescribing in the United Kingdom. In their view, therapy may be prescribed not only to men with a clearly defined need, but also to people with nonspecific symptoms and borderline test results, for whom the balance between benefits and long-term risks is less certain, News-Medical reports.
Growth of the private market
The commentary’s authors, Stephen Atkin and Eric Kilpatrick, noted that in 2024 the UK market for testosterone replacement therapy was estimated at about $205 million. It is expected to reach $365 million by 2032. Meanwhile, within the United Kingdom’s National Health Service, the number of testosterone dispensations at pharmacies increased by 52% between 2020/21 and 2024/25.
In England, a tenfold increase in prescriptions for testosterone gel for women aged 50 and over was also recorded between 2015 and 2022. The researchers point out that private prescriptions are not centrally recorded, so the exact scale of such treatment is unknown. At the same time, in their assessment, its expansion is indicated by the emergence of private and online clinics, monthly subscription models costing from £100 to £375, and active advertising on social media, through influencers, and on outdoor media.
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Diagnosis and monitoring issues
Diagnosing testosterone deficiency requires time and repeat tests. The authors noted that there are no data on how consistently private providers follow this approach. In their view, models offering rapid access to therapy, built around advertising nonspecific symptoms, fail to take into account the complexity of the diagnostic process and may lead to unnecessary lifelong treatment.
The experts also drew attention to the need for long-term monitoring because of potential heart and kidney problems. They believe that a significant part of this burden may shift to the National Health Service when patients who started therapy privately turn to family doctors for tests or management of side effects. The authors proposed creating a reporting system for private doctors and pharmacies that would record indications, patient numbers, monitoring, and transfer of care.
