Identifying patients with testosterone deficiency in community pharmacy

Addressing men’s health is always an ongoing conundrum and not just limited to “Movember”. Beyond just addressing this health issue, it is also about saving valuable NHS resources, keeping families together for longer, reducing economic loss and improving health equality.

Community pharmacy can play an important role in the management of men’s health. In particular, testosterone deficiency has far more serious consequences and stronger links with other diseases than previously recognised.

It is a medical condition that negatively affects male sexuality, general health and quality of life, and is an indicator of an increased risk of developing diseases such as diabetes.

Symptoms of testosterone deficiency are broad and include mild anaemia, depression, cardiovascular disorders (hyperlipidaemia, hypertension), physical decline (loss of bone mineral density, fatigue, loss of muscle mass and strength), metabolic disorders (visceral obesity, diabetes), motivational drive, and sexual dysfunction (reduced sexual desire and erectile dysfunction). Diagnosis is based on signs and symptoms, alongside a measurement of testosterone levels.

Patient embarrassment, a perception of ageing and a lack of clinical awareness makes testosterone deficiency an underdiagnosed condition. Pharmacists can help address this problem and dispel myths that this is an old man’s disease.

We can improve awareness of the condition, increase education among colleagues and healthcare professionals and perhaps design services in order to improve and optimise patient care around testosterone deficiency. It is interesting to note that even when a patient has been diagnosed, not all of them will receive appropriate treatment.

Pharmacists’ consultation skills and extensive experience around sensitive issues, taboo subjects and sexual health means we can easily tackle testosterone deficiency in men in the community. We could engage with patients through pharmacy services, such as medicines use reviews, the new medicine service and NHS health checks, while partners of patients may be able to identify if their partner is potentially suffering from erectile dysfunction.

We could make each consultation count by being proactive and recognising that some patients will be at higher risk and their symptoms and ailments, such as lower urinary tract infections, diabetes, etc, may be down to testosterone deficiency. We are in the perfect position to advise and refer patients to get tested to confirm the diagnosis and to receive the right treatment and support.

Sid Dajani



Sid Dajani is a member of the English Pharmacy Board, Royal Pharmaceutical Society. The views above are his and do not necessarily reflect those of the board or the Society — Editor.

Author disclosure and conflicts of interest disclosure:

This correspondence was prompted by a conference at which the author received speaker honoraria from the conference sponsor, Besins Healthcare UK.

  • This correspondence was updated on 18 January 2017 to include an author disclosure statement.
Last updated
The Pharmaceutical Journal, PJ, December 2016, Vol 297, No 7896;297(7896):DOI:10.1211/PJ.2016.20201984

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