Testosterone therapy in erectile dysfunction

Testosterone therapy and erectile dysfunction

Testosterone therapy has been shown to improve sexual desire, morning erections and erectile function (ED), particularly when: (1-4)

• TT is <8nmol/L2 or calculated FT is <0.225nmol/L
• oral ED medications have failed and TT levels are <10.4nmol/L

In patients with ED, appropriate testosterone therapy (T therapy) may also reduce the need for more expansive and invasive second- and third-line treatments.4

A phosphodiesterase 5 inhibitor (PDE5i) can be co-prescribed to all men with ED when starting T therapy, in the absence of contraindications, because it can take many months for T therapy to correct ED.

References

1. Lee H, Hwang EC, Oh CK, et al. Testosterone replacement in men with sexual dysfunction. Cochrane Database Syst Rev. 2024 Jan 15;1(1):CD013071.
2. Elliott J, Kelly SE, Millar AC, et al. Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis. BMJ Open. 2017 Nov 16;7(11):e015284.
3. Jayasena CN, Anderson RA, Llahana S, et al. Society for Endocrinology guidelines for testosterone replacement therapy in male hypogonadism. Clin Endocrinol (Oxf). 2022 Feb;96(2):200-19.
4. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018 May 1;103(5):1715-44.