Diagnosis and management of male hypogonadism in Germany.

The prevalence of primary hypogonadism exceeded that of secondary and functional hypogonadism among male state insurance clients in Germany.

• Study analyzed data from four million male state insurance clients aged 30 to 80 from 2014 to 2021
• Prevalence of primary hypogonadism was 0.62%
• Prevalence of secondary hypogonadism was 0.16%
• Prevalence of functional hypogonadism was 0.09%
• Both incidence and prevalence of hypogonadism rose from 2015 to 2021

Common comorbidities associated with male hypogonadism included primary hypertension, back pain, and dyslipidemia.

• Comorbidities were evaluated across all three hypogonadism subtypes (primary, secondary, and functional)
• Data were derived from a retrospective observational study covering 2014 to 2021
• The study population consisted of approximately four million male state insurance clients aged 30 to 80

Testosterone therapy (TTh) initiation rates within the first year post-diagnosis varied by hypogonadism subtype, with functional hypogonadism patients receiving treatment most frequently.

• TTh was initiated in 35.22% of patients with primary hypogonadism within the first year post-diagnosis
• TTh was initiated in 36.60% of patients with secondary hypogonadism within the first year post-diagnosis
• TTh was initiated in 59.55% of patients with functional hypogonadism within the first year post-diagnosis
• TTh was administered via transdermal or intramuscular routes

Untreated primary hypogonadism patients had significantly higher work incapacity rates compared to treated patients.

• Work incapacity rate was 17.1% in untreated primary hypogonadism patients
• Work incapacity rate was 9.71% in treated primary hypogonadism patients
• The difference was statistically significant (p < 0.001)

Treated hypogonadism patients had a higher incidence of newly diagnosed type 2 diabetes compared to untreated patients.

• Incidence of newly diagnosed type 2 diabetes was 24.0% in treated patients
• Incidence of newly diagnosed type 2 diabetes was 17.7% in untreated patients
• The difference was statistically significant (p < 0.001)
• This finding was described as a 'conversely' noted outcome relative to the work incapacity benefit seen in treated patients