Testosterone therapy improves sexual desire and activity across almost all domains in symptomatic older men with low libido and low testosterone levels, with responses linked to changes in both testosterone and estradiol levels, say US researchers.
The research, which was published online in the Journal of Clinical Endocrinology & Metabolism on June 29, is a further analysis of data from the Sexual Function Trial, which forms part of a coordinated set of seven double-blind, placebo-controlled studies in the Testosterone Trial.
As previously reported by Medscape Medical News, testosterone therapy in the Sexual Function Trial was associated with a significant increase in sexual activity, as determined by the Psychosexual Daily Questionnaire (PDQ) score, as well as in sexual desire and erectile function.
The current analysis, led by Glenn R Cunningham, MD, of Baylor College of Medicine and Baylor St Luke’s Medical Center in Houston, Texas, takes a deeper dive and indicates that testosterone therapy improved 10 of the 12 domains of sexual activity on the PDQ, with the most notable impact on measures associated with libido.
Talking to Medscape Medical News, Dr Cunningham said: “What I think these studies have shown is that, even in older men who are testosterone deficient and who have decreased libido, testosterone treatment can be beneficial in terms of sexual function and not only in terms of libido but also in terms of erectile function and sexual activity.”
However, he emphasized that the risks and benefits have to be weighed and age taken into consideration when contemplating treating a man with symptoms and low testosterone levels.
“In younger men you tend to have more potential for benefits than risks,” he said. “As you get into middle age and older, then there’s a greater potential for risk.”
Unresolved Issues, but Testosterone Good for Low Libido, if Levels Are Low
Dr Cunningham noted that the “two major unresolved issues” are whether testosterone could increase the potential for an occult prostate cancer to become a clinical prostate cancer and whether it could increase cardiovascular risk.
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