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Testosterone Treatment and Sexual Function in Men: Secondary Analysis of the T4DM (Testosterone for Diabetes) Trial

Gary A Wittert1,2, Kristy P Robledo3, David J Handelsman4

  • 1Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5000, Australia.

The Journal of Clinical Endocrinology and Metabolism
|February 10, 2025
PubMed
Abstract

Insights

Testosterone treatment improved sexual desire and erectile function in men at high risk for type 2 diabetes. Lifestyle changes like reduced waist circumference and depression also boosted sexual health.

Area of Science:

  • Endocrinology
  • Men's Health
  • Metabolic Health

Background:

  • The impact of testosterone therapy combined with lifestyle interventions on sexual function in men at high risk for type 2 diabetes remains unclear.
  • Men aged 50-74 at high risk for or newly diagnosed with type 2 diabetes (OGTT) were studied.

Purpose of the Study:

  • To evaluate the efficacy of testosterone treatment alongside a lifestyle intervention on sexual function in men aged 50-74 at high risk for or with new-onset type 2 diabetes.

Main Methods:

  • A secondary analysis of the Testosterone for the Prevention of Type 2 Diabetes (T4DM) trial.
  • Participants received intramuscular testosterone undecanoate (1000 mg) or placebo every 3 months for 2 years, combined with a lifestyle program.
  • Sexual function was assessed using the International Index of Erectile Function (IIEF)-15 questionnaire.

Main Results:

  • Testosterone treatment significantly improved all five IIEF-15 domain scores, particularly sexual desire and orgasmic function in older men.
  • Improvements in erectile function were linked to reduced waist circumference, and better sexual function correlated with decreased depression scores.
  • Clinically significant improvements in erectile function and sexual desire were observed, with varying effects based on age and baseline function.

Conclusions:

  • Testosterone therapy enhances sexual desire and, to a lesser degree, erectile function in at-risk men, especially older individuals or those with higher waist circumference or depressive symptoms.
  • Independent of testosterone treatment, reductions in waist circumference and depression positively impacted sexual function.
  • The findings suggest a dual approach combining testosterone therapy and lifestyle modification for optimizing sexual health in this population.
Keywords:
clinical trialdiabetesobesitysexual functiontestosterone

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