Factors affecting adherence to testosterone replacement therapy

Aim: There are several treatment modalities for testosterone replacement therapy (TRT), including topical gels, subcutaneous testosterone pellets, transdermal patches, intramuscular injectables and oral forms. Despite the increasing usage of testosterone, there is limited information concerning patient adherence and compatibility of TRT. The aim of this study is to evaluate the factors which may have an impact on patients' adherence to TRT with topical gel. Methods: Between January 2013 and September 2013, 60 men from a tertiary urology clinic, who were prescribed 50 mg testosterone topical gel, were telephonically contacted to know if they continued or discontinued TRT, and when discontinued, the reasons for the same. Results: The mean age of the patients was 40.9 ± 9.9 (range: 21–59) years. The participation rate for the study through telephone was 51.6% (31/60). The most common reason for discontinued TRT was lack of perceived efficacy [n = 11 (35.5%)]. Factors, including age, weight, height, relationship status, and presence of comorbidity, were not associated with TRT adherence. The mean (standard error) time to TRT withdrawal was 5.9 (0.9) months. Conclusion: Most men voluntarily decided to discontinue testosterone and thus a close monitoring of patients by clinicians is essential to increase TRT adherence rate, with testosterone topical gel.