Evidence map›Paper›PMID 41489427›Full record

ArticleThe Journal of clinical endocrinology and metabolism2026

Discordance Between Online Information and Male Hypogonadism Clinical Guidelines: A Global Multilingual Content Analysis.

Bonnie Grant, Nipun Lakshitha de Silva, Maha Gumssani, Oliver Quinton, Faysal Kayali, Isuru Lakmith Gamage, Waljit S Dhillo, Mathis Grossmann, Channa N Jayasena

Abstract read
In one paragraph

Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Bonnie GrantSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0003-1121-9211
Nipun Lakshitha de SilvaSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0002-4467-3659
Maha GumssaniSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
Oliver QuintonSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.
Faysal KayaliImperial College Healthcare NHS Trust, The Bays, London W2 1NY, UK.
Isuru Lakmith GamageDepartment of Endocrinology, Austin Health, Heidelberg, Victoria 3084, Australia.
Waljit S DhilloSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0001-5950-4316
Mathis GrossmannDepartment of Endocrinology, Austin Health, Heidelberg, Victoria 3084, Australia.ORCID 0000-0001-8261-3457
Channa N JayasenaSection of Investigative Medicine, Imperial College London, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0002-2578-8223

Funding

MedicalNationalNIHR Biomedical Research Centre Funding SchemeNIHR/Imperial Clinical Research FacilityNIHR Post-Doctoral Fellowship (C.N.J.)NIHR Senior Investigator Award (W.S.D.)
6 · The paper itself

Abstract

contextTestosterone prescriptions have increased up to 12-fold globally over the past 2 decades. EU and UK law tightly regulate the advertising of medical products.

objectiveTo review the accuracy of publicly accessible information on websites offering testosterone treatment. DESIGN/

settingContent analysis methodology using concept- and data-driven strategies to develop a coding frame for data extraction. Publicly accessible websites offering testosterone prescriptions were identified using predefined search terms, conducted in English, Arabic, Hindi, and Spanish, across 3 search engines. Virtual private network searches within multiple geographical regions were used to reduce location bias.

main outcome measureAccuracy of extracted data determined using international guidelines.

resultsA total of 253/1138 websites were included (144 US/Canada; 48 Europe; 17 Australia; 12 Asia; 11 South America; 10 Middle East). The following non-guideline-based practices (with numbers/percentages of clinics) were identified: routinely use nontestosterone androgens or testosterone secretagogues (eg, gonadotrophins) to treat symptomatic low testosterone (61/253; 24.4%); testosterone treatment reduces cardiovascular risk (52/253; 20.6%); microdosing improves treatment effects (30/253; 11.9%); testosterone is prescribed for men with normal serum testosterone (>12 nmol/L; 25/253;9.9%); testosterone has antiaging effects (25/253; 9.9%). US-based clinics more frequently made non-guideline-based claims compared with other geographical locations.

conclusionWe identify serious and frequent breaches of advertising law and regulations by clinics around the world offering testosterone treatment, with the potential to cause harm to men. We recommend enforcement of existing laws by national regulators to address this widespread public health challenge and align patient expectations with clinical guidelines for the safe treatment of men.

Indexed as

HypogonadismInternetPractice Guidelines as TopicTestosteroneHormone Replacement TherapyHumansMaleMultilingualismTestosteroneandropausecontent analysismale hypogonadismtestosteroneTRT

Identifiers

PMID41489427
PMCPMC13183426

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.