Is testosterone supplementation effective for ED?

The short answer is yes – in some, but not all – cases where testosterone levels are low.

Approximately 10 to 15 percent of men with erectile dysfunction suffer from low testosterone levels. Yet up to a quarter of all men are estimated to have low testosterone levels, with that number rising as men age – and it’s not clear why some, but not all, experience ED as a consequence.

What is clear is that when low testosterone is the cause of ED, 40 to 60 percent of men benefit from testosterone supplementation. When other factors – poor blood supply to penis, stress, etc – are involved – testosterone treatment alone is not nearly as effective in curing erectile dysfunction, even though it may increase sexual desire.

Now it’s become clear that testosterone supplements can give a big boost to men who don’t respond to impotence drugs like Viagra, Levitra and Cialis. It is estimated a significant proportion of men – between 25 and 50 per cent – do not respond to the medications which have become known as PDE5 inhibitors.

When testosterone is added to the therapy up to 70 per cent of men with low testosterone find the cure for erectile dysfunction, as well as improving their orgasms and overall quality of life.

The same strong result was found in men with low testosterone using long acting testosterone therapy alone, who received testosterone injections at six weeks and then three monthly intervals.

After twelve and 30 weeks of testosterone treatment, 20 out of the 29 patients demonstrated marked improvement in erectile function, without using any other medication.

As a result, men’s health organisations are reporting a change in the attitude to the use of testosterone supplements – which recent studies have found can be helpful in treating conditions linked with male ageing like tiredness, depression, and lack of libido.

Recent studies have also suggested that the effects of an age-related lack of testosterone may go beyond feeling a bit tired, with type 2 diabetes, obesity and cardiovascular disease appearing to be linked with it.

Another reason for updating the guidelines on who to screen for testosterone deficiency and how to treat it lies in the results of some studies that suggest that some of the fears about testosterone supplements increasing the risk of prostate cancer may have been unfounded.

The new guidelines recommend measuring testosterone in all men who have both type 2 diabetes and symptoms of testosterone deficiency, and in those with erectile dysfunction or low libido.

“This is a major change. That puts a lot of people in the category of being screened for low testosterone,” says Andre Araujo, director of epidemiology at the New England Research Institutes in Watertown, Massachusetts.

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