Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels

Cunningham, Glenn R.; Stephens‐Shields, Alisa J.; Rosen, Raymond C.; Wang, Christina; Bhasin, Shalender; Matsumoto, Alvin M.; Parsons, J. Kellogg; Gill, Thomas M.; Molitch, Mark E.; Farrar, John T.; Cella, David; Barrett‐Connor, Elizabeth; Cauley, Jane A.; Cifelli, Denise; Crandall, Jill P.; Ensrud, Kristine E.; Gallagher, Laura J.; Zeldow, Bret; Lewis, Cora E.; Pahor, Marco; Swerdloff, Ronald S.; Hou, Xiaoling; Anton, Stephen; Basaria, Shehzad; Diem, Susan J.; Tabatabaie, Vafa; Ellenberg, Susan S.; Snyder, Peter J.

doi:10.1210/jc.2016-1645

Cited by 122 publications

(88 citation statements)

References 43 publications

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“…260 An RCT in 470 men aged >65 years with testosterone levels <275 ng/dL found that testosterone gel led to improvements in sexual function, desire, and activity. 261,262 Other studies have shown that the addition of testosterone to PDE5i therapy in men with low serum testosterone levels helps improve ED. 263–268 Testosterone therapy should not be used if contraindicated by the primary oncologic diagnosis (eg, prostate cancer on active surveillance, prostate cancer on ADT).…”

Section: Sexual Dysfunctionmentioning

confidence: 99%

Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Denlinger¹,

Sanft²,

Baker³

et al. 2017

J Natl Compr Canc Netw

106

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Many cancer survivors experience menopausal symptoms, including female survivors taking aromatase inhibitors or with a history of oophorectomy or chemotherapy, and male survivors who received or are receiving androgen-ablative therapies. Sexual dysfunction is also common in cancer survivors. Sexual dysfunction and menopause-related symptoms can increase distress and have a significant negative impact on quality of life. This portion of the NCCN Guidelines for Survivorship provide recommendations for screening, evaluation, and treatment of sexual dysfunction and menopausal symptoms to help healthcare professionals who work with survivors of adult-onset cancer in the posttreatment period.

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Section: Sexual Dysfunctionmentioning

confidence: 99%

Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Denlinger¹,

Sanft²,

Baker³

et al. 2017

J Natl Compr Canc Netw

106

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“…Studies have observed that men who have been placed on androgen deprivation therapy (ADT) for prostate cancer have a dramatic reduction in erectile function with a decrease in testosterone levels [16–18]. Finally, numerous randomized controlled trials (RCTs) have demonstrated that erectile function improves when testosterone is given to men with low testosterone levels [19–24]. …”

Section: Testosterone Therapy Improves Symptoms Of Mild Erectile Dysfmentioning

confidence: 99%

“…The recently published Testosterone Trials – a set of RCTs of 790 men with late onset hypogonadism randomly assigned to either testosterone gel or placebo – demonstrated that after 1 year of treatment that men who used testosterone gel had an IIEF-ED score 2.64 points [95% Confidence Interval (CI): 1.06 – 4.02] greater than men who had been assigned to the placebo arm [24]. It is important to note that men enrolled in this study on average had moderate ED, and so this improvement in erectile function was not considered clinically significant.…”

Section: Testosterone Therapy Improves Symptoms Of Mild Erectile Dysfmentioning

confidence: 99%

“…Recently, the Sexual Function sub-trial of the Testosterone Trials examined sexual desire. This placebo-controlled trial included 470 men aged 65 years or older with testosterone levels less than <275 ng/dL [24]. When assessing the impact of TTh on sexual symptoms, the authors used the Derogatis Interview for Sexual Function-Sexual Desire Domain, comprised of 25 scored items, and found that libido improved proportionately with increase in testosterone levels, with an effect size of 0.44 [95% Confidence Interval: 0.32 – 0.56] [40].…”

Section: Testosterone Therapy and Libidomentioning

confidence: 99%

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Testosterone therapy improves erectile function and libido in hypogonadal men

Rizk

Kohn²,

Pastuszak³

et al. 2017

Current Opinion in Urology

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Purpose of Review Erectile dysfunction (ED) and decreased libido are common complaints in the older male population. Recent studies have elucidated the role testosterone therapy (TTh) can play in men with low testosterone levels. The aim of this review is to provide an overview of these findings and the utility of TTh. We specifically examine the role of TTh on erectile function, co-administration with phosphodiesterase type 5 (PDE5) inhibitors, and libido. Recent Findings Recent publications suggest that TTh improves mild ED, though may be less useful in men with more severe ED. In men unresponsive to PDE5 inhibitors and with mild ED, TTh can further improve erectile function. Testosterone therapy has also shown consistent benefit in improving libido in men with low testosterone levels at baseline, with no additional improvements once testosterone levels are normalized. Summary The available literature supports a role for TTh in men with low testosterone levels, ED, and low libido, with symptomatic improvement in these men.

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“…In terms of validity of the study design, randomized controlled trials (RCT’s) have the highest validity, followed by prospective studies. However, most randomized trials of TTh are not powered to investigate their effect on CVD outcomes (28). …”

Section: High Serum Total- Free- and Bioavailable-testosterone And Cmentioning

confidence: 99%

Testosterone replacement therapy and the heart: friend, foe or bystander?

López¹,

Canfield²,

Wang³

2016

Transl. Androl. Urol.

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The role of testosterone therapy (TTh) in cardiovascular disease (CVD) outcomes is still controversial, and it seems will remain inconclusive for the moment. An extensive body of literature has investigated the association of endogenous testosterone and use of TTh with CVD events including several meta-analyses. In some instances, a number of studies reported beneficial effects of TTh on CVD events and in other instances the body of literature reported detrimental effects or no effects at all. Yet, no review article has scrutinized this body of literature using the magnitude of associations and statistical significance reported from this relationship. We critically reviewed the previous and emerging body of literature that investigated the association of endogenous testosterone and use of TTh with CVD events (only fatal and nonfatal). These studies were divided into three groups, “beneficial (friendly use)”, “detrimental (foe)” and “no effects at all (bystander)”, based on their magnitude of associations and statistical significance from original research studies and meta-analyses of epidemiological studies and of randomized controlled trials (RCT’s). In this review article, the studies reporting a significant association of high levels of testosterone with a reduced risk of CVD events in original prospective studies and meta-analyses of cross-sectional and prospective studies seems to be more consistent. However, the number of meta-analyses of RCT’s does not provide a clear picture after we divided it into the beneficial, detrimental or no effects all groups using their magnitudes of association and statistical significance. From this review, we suggest that we need a study or number of studies that have the adequate power, epidemiological, and clinical data to provide a definitive conclusion on whether the effect of TTh on the natural history of CVD is real or not.

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Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels

Abstract: In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.

Cited by 122 publications

References 43 publications

Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Survivorship, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology

Testosterone therapy improves erectile function and libido in hypogonadal men

Testosterone replacement therapy and the heart: friend, foe or bystander?

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