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Testosterone Doesn't Improve Erectile Function When Added to Sildenafil

The addition of testosterone to sildenafil does not appear to improve erectile function in men with low testosterone, according to an Annals of Internal Medicine study.

During a 3- to 7-week run-in phase, 140 men with erectile dysfunction (ED) and low testosterone levels were given dose-optimized sildenafil. They were then randomized to either transdermal testosterone or placebo gel for 14 weeks.

After sildenafil treatment, both groups experienced an improvement in erectile function. But after the addition of testosterone, there were no significant differences between the groups in any measure of sexual function. The authors speculate that sildenafil may have raised men's testosterone levels enough so that additional testosterone would not have an effect. The authors note that they did not test the effect of testosterone alone.

They conclude that the findings "do not support the routine addition of testosterone therapy for improving erectile response to selective PDE5 inhibitors in men with ED who have low testosterone levels, which has become commonplace in clinical practice."

LINK(S):

Annals of Internal Medicine article (Free abstract)

Background: Journal Watch General Medicine year in review article on testosterone supplementation (Your Journal Watch registration required)

Published in Physician's First Watch November 20, 2012

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