TESTOSTERONE treatment may alter respiratory medication use in people taking inhaled corticosteroids, new registry data suggest.
Testosterone Treatment And Inhaled Corticosteroid Use
Systemic testosterone treatment was associated with a delayed reduction in inhaled corticosteroid use among males already prescribed inhaled corticosteroids, according to a nationwide population-based cohort study. However, the findings also showed increased short-acting beta-agonist use in older adults, underscoring a complex relationship between androgen therapy and airway symptoms.
The study included 858 male individuals treated with inhaled corticosteroids who initiated systemic testosterone therapy between 1995 and 2022. Participants had a mean age of 51 years, and outcomes were assessed using national Danish health and prescription registry data. Investigators compared medication patterns and exacerbation rates before and after testosterone initiation using a within-subject design.
Inhaled corticosteroid exposure remained stable during the first 18 months after testosterone treatment began. A statistically significant reduction emerged between 18 and 24 months, with a mean decrease of 54 μg in budesonide-equivalent dose. Subgroup analyses suggested that this reduction was mainly seen among participants with chronic obstructive pulmonary disease, rather than those with asthma or asthma and COPD overlap.
Older Adults Show Higher Reliever Medication Use
Despite the reduction in inhaled corticosteroid use, short-acting beta-agonist use increased after testosterone treatment initiation. The overall increase was not statistically significant, but among participants older than 45 years, SABA use rose by a mean of 111 doses per half year.
Exacerbation rates did not change significantly after androgen therapy was initiated. However, the authors noted numerical trends toward higher annualized exacerbation rates, meaning the clinical implications remain uncertain.
The delayed reduction in inhaled corticosteroid requirements may reflect a gradual immunomodulatory effect of testosterone, although the study cannot establish causality. The authors also highlighted that prescription fill data may not reflect actual adherence, disease control, or the precise indication for testosterone treatment in all participants.
These findings suggest that testosterone treatment may influence long-term respiratory medication patterns in selected patients. Still, the concurrent rise in reliever medication use, particularly in older adults, supports careful monitoring when systemic androgens are prescribed to people with obstructive airway disease.
Reference
Hansen ESH et al. Testosterone treatment and respiratory medications and exacerbations in people prescribed inhaled corticosteroids: a nationwide cohort study. Respiratory Medicine. 2026;260:108910.
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