Danish men are increasingly being prescribed testosterone in topical gel form rather than injections, with daily gels now dominant in the national prescription mix, even as official guidelines warn that inappropriate hormone therapy can suppress sperm production and raise haematocrit with possible thromboembolic risk.
According to the Danish Medicines Agency, testosterone prescribing has shifted sharply toward topical gels, which now account for roughly two-thirds of all testosterone defined daily doses dispensed nationally, while injectable testosterone has fallen to below 10 percent of use. The overall number of men receiving at least one testosterone prescription has doubled over the past decade, with Sundhedsdatastyrelsen data reported by TV 2 showing 5,885 men received testosterone in 2024, up 44 percent from 2023.
Testosterone prescribing in Denmark’s gatekeeping system
Denmark’s GP gatekeeper system means specialist hormone treatment generally requires a GP referral, which in theory limits casual access. Yet the formulation shift suggests that once a prescription is issued, men are choosing long-term, at-home therapy. The problem is that genuine testosterone deficiency remains relatively rare, with international estimates placing pathological hypogonadism at around 2 to 6 percent of middle-aged men.
According to the Danish Endocrine Society’s clinical guideline on male hypogonadism, testosterone treatment is indicated only when persistently low morning testosterone is confirmed on at least two separate occasions, accompanied by clear symptoms such as reduced libido, erectile dysfunction or loss of muscle mass. The guidelines also state that obesity, type 2 diabetes, sleep apnoea and certain medicines frequently cause low testosterone. They recommend addressing these conditions first, before hormone therapy is considered.
That advice is being overlooked. According to Sundhedsstyrelsen national health profile tables, 19.3 percent of adult men were obese in 2021, up from 13.3 percent in 2010, an increase of around 45 percent over a decade. Over the same period, hospital diagnoses of male hypogonadism have increased substantially, though absolute numbers remain low.
The fertility collision
For internationals living in Denmark, the testosterone story intersects directly with reproductive health. According to the European Academy of Andrology and Endocrine Society consensus, exogenous testosterone suppresses the hypothalamic-pituitary-testicular axis and can reduce sperm production to zero, effectively functioning as a male contraceptive. Recovery can take months to years after stopping therapy.
Danish guidelines are explicit that testosterone therapy is contraindicated in men trying to conceive. Fertility-preserving drugs that stimulate natural production, such as gonadotropins, should be used instead.
According to Statistics Denmark and Eurostat, Denmark’s total fertility rate has fallen from 1.88 children per woman in 2010 to 1.55 in 2023, compared with Finland at 1.44 and France at 1.79. The endocrine and fertility trends are moving in opposite directions.
What international research on testosterone levels shows
New international research presented in London in 2026 suggests that men’s average testosterone levels in high-income countries have declined sharply over the past five decades, with some analyses indicating a roughly 50 percent reduction since the early 1970s. Danish experts urge caution. Over this period, laboratories switched from older radioimmunoassay methods to modern mass spectrometry, and reference ranges were recalibrated, which can shift measured values even if biology is unchanged.
What has changed for certain is waist circumference and metabolic health. According to Sundhedsstyrelsen BMI trend data, Danish men’s average BMI rose from roughly 25.5 in 1994 to about 27.0 in 2021, moving the average man from upper-normal weight into the overweight range. The Danish Endocrine Society guideline states that in men with obesity and type 2 diabetes, low testosterone is often secondary to the disease, and that weight loss and optimisation of metabolic control should be attempted before starting therapy.
The private clinic push
Some private clinics in Denmark promote testosterone optimisation as part of men’s health packages, highlighting fatigue and low libido in midlife. Industry-funded campaigns internationally have framed testosterone therapy as treatment for a broad range of non-specific symptoms, beyond strict hypogonadism indications. Danish academic endocrinologists warn that overtreatment risks harm. According to Sundhed.dk, testosterone therapy can increase haematocrit, thickening the blood and raising the risk of clots, and can worsen prostate symptoms.
Danish endocrinologists interviewed by TV 2 and Information have warned that some men seek testosterone as a quick fix for ageing, raising concern about lifestyle-driven use. According to Sundhedsstyrelsen health profile data, the share of Danish men who meet physical activity recommendations fell from about 70 percent in 2010 to around 62 percent in 2021.
What men should do
The pathway starts with your general practitioner, who orders early-morning testosterone tests and repeats them if levels are low. If levels are borderline, guidelines recommend addressing reversible causes such as weight loss, improved sleep and reduced alcohol before considering hormones. Men with suspected pituitary disease or severe symptoms are referred to hospital endocrinology departments at regional hospitals such as Herlev, Aarhus or Odense.
Men worried about fertility are advised to contact a fertility clinic for semen analysis before starting any hormone therapy. This is often covered by the public system if a GP refers the couple. For internationals, the International Citizen Service and municipal Life in Denmark portals provide English-language guidance on how to register with a GP and access specialist care. Denmark’s emphasis on lifestyle change first, hormones second, may contrast sharply with experiences in home countries.
