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Testosterone therapy in erectile dysfunction.

R Shabsigh1

  • 1Department of Urology, Columbia University, New York, NY 10032, USA.

The Aging Male : the Official Journal of the International Society for the Study of the Aging Male
|April 1, 2005
PubMed
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Testosterone therapy improves erectile dysfunction in men with low testosterone who don't respond to sildenafil alone. Combining testosterone gel with sildenafil enhances erectile response, suggesting screening for hypogonadism in non-responders is crucial.

Area of Science:

  • Andrology
  • Urology
  • Endocrinology

Background:

  • Nitric oxide pathway for erections is testosterone-dependent.
  • Castration causes erectile dysfunction and negatively impacts penile hemodynamics.
  • Testosterone replenishment reverses these adverse effects.

Purpose of the Study:

  • To evaluate the efficacy of testosterone gel combined with sildenafil in hypogonadal men with erectile dysfunction.
  • To assess if testosterone therapy improves response to sildenafil in non-responders.

Main Methods:

  • Multicenter study involving hypogonadal men with erectile dysfunction unresponsive to sildenafil alone.
  • Randomized trial comparing testosterone gel + sildenafil vs. placebo gel + sildenafil for 12 weeks.
  • Primary outcome: change in Erectile Function domain of the International Index of Erectile Function (IIEF).

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Main Results:

  • Testosterone gel combined with sildenafil significantly improved erectile response compared to placebo.
  • Improvements were observed in other IIEF domains and total scores.

Conclusions:

  • Testosterone therapy, specifically with testosterone gel, is effective in treating erectile dysfunction in men with low testosterone levels who have not responded to sildenafil alone.
  • Screening for hypogonadism is recommended for men experiencing erectile dysfunction despite PDE5 inhibitor treatment.