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Testosterone Replacement Therapy for Sexual Symptoms.

Giulia Rastrelli1, Federica Guaraldi2, Yacov Reismann3

  • 1Sexual Medicine and Andrology Unit, Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy.

Sexual Medicine Reviews
|February 27, 2019
PubMed
Summary

Testosterone replacement therapy (TRT) can improve libido, erectile function, and sexual satisfaction in hypogonadal men. However, TRT is most effective for milder erectile dysfunction and requires further study for orgasmic function.

Keywords:
EjaculationErectile DysfunctionSexual DesireTestosteroneTestosterone Replacement Therapy

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Area of Science:

  • Endocrinology
  • Sexual Medicine
  • Pharmacology

Background:

  • The endocrine system, particularly androgens, is crucial for male sexual response.
  • Testosterone replacement therapy (TRT) is a key treatment for hypogonadal men with erectile dysfunction.

Purpose of the Study:

  • To review evidence on testosterone's role in male sexual function.
  • To summarize sexual outcomes of TRT in patients with sexual dysfunction.

Main Methods:

  • A comprehensive PubMed literature search was conducted.
  • Preclinical and clinical evidence on testosterone's role and TRT outcomes were analyzed.

Main Results:

  • Testosterone modulates male sexual response, though its role in general population studies is less clear due to multifactorial influences.
  • TRT can improve libido, erectile function, and sexual satisfaction.
  • Evidence for TRT improving orgasmic function is conflicting; further research on TRT combined with PDE5 inhibitors is needed.

Conclusions:

  • TRT benefits are observed in hypogonadal men (total testosterone < 12 nmol/L).
  • TRT alone is effective for mild erectile dysfunction; severe cases may require combination therapy.