(391) Comparative Analysis of YouTube and TikTok Videos on Treatments for Low Testosterone
Authors: Pandher M , Fastenau J , Shah P , Mina G , Fernandez Pedrosa G , Nguyen A , Sadeghi-Nejad H 
Published: May 2023

Abstract

Introduction
Low testosterone is a common finding in aging men. Symptoms of low testosterone include fatigue, loss of libido, depression, and erectile dysfunction, among others. American Urologic Association (AUA) guideline approved treatments for low testosterone include testosterone replacement therapy (TRT) either intranasally, intramuscularly, topically, or subdermally. Social media has become critical in the way patients obtain their medical information, including information surrounding treatment for low testosterone. TikTok and YouTube are two such popular social media video-sharing platforms.

Objective
To survey the different modalities to increase testosterone levels represented on YouTube and TikTok, and compare the content and quality of their videos.

Methods
“Testosterone treatment” was searched on YouTube and TikTok in June 2022 using private browser settings on Google Chrome. The top 60 YouTube and TikTok videos were selected. Exclusion criteria included YouTube videos longer than 10 minutes, due to evidence showing longer videos resulted in decreased viewer engagement, and videos that did not mention ways of increasing testosterone. This left 59 YouTube videos and 55 TikTok videos. Videos were reviewed by two independent researchers. Information collected included publication date, length, views, likes, comments, subscribers/followers, presence of US certified medical professional, scientific article cited or displayed, type of person posting video, methods of increasing testosterone, side effects of testosterone treatment, modified DISCERN score and Patient Materials Assessment Tool (PEMAT). U.S. medical professional certification was determined using certificationmatters.org. The PEMAT score evaluated 17 items regarding understandability and actionability. The modified DISCERN based reliability score ranked quality from 1 = poor, to 5 = excellent. Data was analyzed using SPSS statistics software v24.

Results
The average YouTube video was of 4.01 minutes in length and had 94,108 views, 137 comments, 1,172 likes, and 629,607 subscribers. The average TikTok video was 0.84 minutes long and had 144,707 views, 121 comments, 6,509 likes, and 163,344 followers. YouTube videos had a significantly higher DISCERN reliability score than TikTok videos (3.14 vs 1.35; p&lt;0.001), although the PEMAT Understandability (81.0 vs 77.7; p=0.166) and Actionability Scores (49.9 vs 40.0; p=0.132) were not significantly different. Most video publishers on both YouTube and TikTok were laypersons. YouTube had a significantly higher number of certified medical professionals and inclusion of scientific articles than TikTok (p=0.009). Natural ways of increasing testosterone including changes in diet, exercise, and use of supplements such as ashwagandha, zinc, tongkat ali, and fadogia agrestis, were mentioned significantly more on TikTok compared to YouTube (31.5% vs 13.8%, p = 0.025). YouTube videos mentioned forms of hormonal TRT more often than TikTok videos. 52.7% of all videos described side effects related to increased testosterone, with TikToks describing side effects more than YouTube (p&lt;0.001).

Conclusions
While YouTube videos contain more reliable information for patients with low testosterone than TikToks, both platforms will benefit from medical professionals playing an active role in creating comprehensive videos about treatment.

Disclosure
No