testosterone therapy in erectile dysfunction

Last edited 01/2023 and last reviewed 06/2023

Testosterone therapy and erectile dysfunction

Testosterone therapy has been shown to improve sexual desire, morning erections and erectile function,1,2 particularly when:1-3

• 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 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. British Society of Sexual Medicine. Guidelines on the management of sexual problems in men: the role of androgens 2010.
• 2. Dean JD, McMahon CG, Guay AT, et al. The International Society for Sexual Medicine's process of care for the assessment and management of testosterone deficiency in adult men. J Sex Med 2015;12:1660-1686.
• 3. Buvat J, Montorsi F, Maggi M, et al. Hypogonadal men nonresponders to the PDE5 inhibitor tadalafil benefit from normalization of testosterone levels with a 1% hydroalcoholic testosterone gel in the treatment of erectile dysfunction (TADTEST study). J Sex Med 2011;8:284-293.
• 4. Lowe G, Bahnson R. Non-invasive management of primary phosphodiesterase type 5 inhibitor failure in patients with erectile dysfunction. Ther Adv Urol 2010;1:235-242.