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Testosterone therapy effectively improves sexual activity in older men
Testosterone therapy consistently improved most types of sexual activity in symptomatic older men with low testosterone levels.
“Our findings indicate low testosterone is one cause contributing to reduced libido and erectile dysfunction in older men,” Glenn R. Cunningham, MD, of Baylor College of Medicine and Baylor St. Luke’s Medical Center in Houston, said in a press release. “Men experiencing these symptoms should be evaluated for testosterone deficiency.”
Cunningham and colleagues evaluated data from the Testosterone Trials on 470 men aged 65 years or older with low libido, average testosterone less than 275 ng/dL and a partner willing to have sexual intercourse at least twice a month. Participants were randomly assigned to testosterone gel (AndroGel 1%, AbbVie; n = 234) or placebo (n = 236). The initial dose was 5 mg daily, and serum testosterone concentrations were measured a 1, 2, 3, 6 and 9 months. Changes in sexual function were assessed from baseline to 3, 6, 9, and 12 months.
Question four of the Psychosexual Daily Questionnaire, which includes12 specific questions about sexual interests and activities, was used to determine the primary outcome of a change in sexual activities over a 7-day period; secondary outcomes included measures of sexual desire and erectile and orgasmic function. The Derogatis Interview for Sexual Function (DISF) was used to evaluate sexual desire, the International Index of Erectile Function (IIEF)-Erectile Function Domain (EFD) was used to evaluate erectile function, and the IIEF-Orgasmic Function Doman (OFD) was used to evaluate orgasmic function. Reduced sexual desire was indicated by a score of less than 20 on the DISF-SDD; a score of less than 22 indicates erectile dysfunction.
Out of 12 measures of sexual activity, only “flirting by others” and “day spontaneous erection” were not associated with significant treatment effects.
Alcohol use influenced the effect of testosterone on sexual desire and sexual activity; more alcoholic drinks per week were linked with testosterone having a greater effect on sexual desire and activity scores. The effect of testosterone on sexual desire was weakened with a history of stroke and higher scores on the International Prostate Symptom Score. The effect of testosterone on erectile dysfunction was also weakened with higher scores on the Positive and Negative Affect Scales and a history of coronary artery disease.
“[Testosterone] treatment of older men with low [testosterone] levels consistently improved most types of sexual activity, sexual desire and erectile function in older men with low libido and low [testosterone] levels,” the researchers wrote. “The improvements in sexual desire, sexual interests and sexual activities were related to changes in [testosterone], free [testosterone] and estradiol levels. We found no clinical characteristics that predicted responsiveness to [testosterone] treatment and no [testosterone] threshold for improving sexual function.” – by Amber Cox
Disclosure: Cunningham reports various financial ties with AbbVie, Apricus, Ardana, Besins, Clarus Therapeutics, Endo Pharma, Ferring, Lilly, Pfizer, Repro Therapeutics, Solvay and Unimed. Please see the full study for a list of all other authors’ relevant financial disclosures.