Testosterone Replacement for ED?
Erectile dysfunction (ED) is a very common problem which becomes more common as men get older. With all of the commercials talking about low testosterone or “low-T,” I get a lot of men concerned that their ED is being caused by a hormone deficit.
Over the past several years, I have tested a lot of men for low testosterone, and have started several of them on testosterone replacement. Unfortunately, from my personal experience with patients, most of the time, there didn't seem to be much improvement in the symptoms we were hoping to improve.
Now, recently I came across this article that reinforced some of my suspicions.
Researchers took a population of men who had low testosterone and were on sildenafil (Viagra). From there, they randomly assigned them to receive either testosterone replacement or a placebo treatment. After a period of time, they looked to see if the men on testosterone had actually found some improvement in their ED symptoms.
The results? No improvement over placebo for the men who took the testosterone - on any measure. Testosterone replacement did not improve the frequency of sexual encounters, percentage of successful sexual intercourse, sexual desire, quality-of-life scores, or marital intimacy scores.
With growing evidence that testosterone replacement causes harm (i.e. heart attacks) and less evidence showing it helps men, it brings up the question - when (if ever) should it be used?
Dr. Jeff M.D.
Spitzer M, Basaria S, Travison TG, et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med. 2012;157(10):681–691.