It is dismaying to see that Australia so often keeps falling on the wrong side of sensible. Judging from our reactions to Essendon FC, peptides and male hormonal support in general, we are virtually medieval. The PBS is no longer going to allow GPs to prescribe testosterone for men (estrogen is fine for women, though) from April 1, on the PBS system. That is unless they get ‘permission’ from a urologist or endocrinologist, neither of whom would have any idea about why men might need testosterone, or indeed, how to give and monitor it. Why is that? Because no medically trained person in Australia has ever been taught how to treat men with testosterone.
Worse, the federal guidelines now show that men’s testosterone levels have to drop so low, that they equal about twice what a women’s levels are when they should be 10 to 20 times that amount. This is not just stupidity, it is the government practicing medicine and it is, to say the least, malpractice at that!
Where the experts come from who advise the government is interesting., Here is a quote from the Medical Journal of Australia’s magazine MJA InSight: Brisbane GP Dr Justin Coleman said the more stringent Pharmaceutical Benefits Scheme (PBS) criteria were necessary to curb the “dangerously fast” increase in testosterone prescribing in Australia, which was unsustainable and probably harmful. He made that up as there is not one properly conducted study to show that this is true.
And: In an editorial published in the Journal of the American Geriatric Society last week, Dr Thomas Perls of the Boston Medical Center and Australia’s Professor David Handelsman, applauded the FDA’s moves to address “disease mongering” of age-related declines in testosterone.
Professor Handelsman, director of the ANZAC Research Institute, told MJA InSight that an overflow effect from international direct-to-consumer advertising and lax US and European prescribing guidelines had fuelled an accelerating increase in testosterone prescribing in Australia in the past two decades, as he had outlined previously in the MJA.
Professor Handelsman, who is also professor of reproductive endocrinology and andrology at the University of Sydney, said although the increase in testosterone prescribing rates in Australia were not as extreme as in the US, Canada or most of the 41 countries analysed in his MJA research, Australia had paralleled the rapidly increasing North American prescribing trends.
He said tightening the PBS prescribing criteria was a step in the right direction and would have some beneficial effect on curbing inappropriate prescribing of testosterone for functional causes of low serum testosterone.
Wow! Whatever we do we must not help men with functional testosterone deficiency. This fear of testosterone is groundless and, to put it bluntly, stupid. It is also sexist, discriminating against men, while women have free access to any hormonal support they desire. Too bad if you have a Y-chromosome and live in Australia.
Dr Coleman does NOT treat men with testosterone deficiencies and as a result his opinions about testosterone usage should carry NO weight! Professor Handelsman presumably doesn’t recognise testosterone deficiency either or he would not be so flippant and come across as utterly ignorant of the value and importance of maintaining optimal hormonal levels.
Here is the medical night-mare. Government legislation based on worthless ‘normal’ testosterone blood values, and non-experts masquerading as such. It’s impossible to be fully male in Australia. Germaine Greer must be smiling…