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Related Experiment Videos

Does testosterone have a role in erectile function?

Nasser Mikhail1

  • 1Endocrinology Division, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, Calif 91342, USA. nmikhail@ladhs.org

The American Journal of Medicine
|May 3, 2006
PubMed
Summary
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Testosterone is essential for normal erections in men, though higher levels may not improve function. Screening for hypogonadism in men with erectile dysfunction (ED) is crucial for identifying those who may benefit from testosterone therapy.

Area of Science:

  • Endocrinology
  • Urology
  • Sexual Medicine

Background:

  • Testosterone's role in libido is established, but its precise contribution to erectile function is less understood.
  • Erectile dysfunction (ED) is a common condition affecting many men, with various potential underlying causes.

Purpose of the Study:

  • To clarify the role of testosterone in male erectile function.
  • To evaluate the therapeutic efficacy of testosterone in managing erectile dysfunction.

Main Methods:

  • A comprehensive literature review was conducted, encompassing studies from 1939 to June 2005.
  • Databases searched included MEDLINE, endocrinology textbooks, and cross-references from relevant articles and reviews.
  • Inclusion criteria covered clinical trials, animal studies, case reports, reviews, and major association guidelines.

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Main Results:

  • Testosterone may act as a vasodilator, potentially facilitating erections.
  • While castration often impairs erection, hypogonadism is found in only about 5% of ED cases.
  • Testosterone therapy showed potential benefits over placebo for hypogonadal men with ED, particularly those with severe hypogonadism.

Conclusions:

  • Low testosterone levels are critical for normal erections, but supra-normal levels offer limited additional benefit.
  • Screening for hypogonadism in men with ED is essential to identify candidates for testosterone treatment.
  • Testosterone therapy may enhance the effectiveness of PDE5 inhibitors in certain patient groups.