Testosterone supplementation failed to improve outcomes among elderly men with mild to moderate erectile dysfunction scores, even though testosterone levels were improved, researchers said. The Sexual Health Inventory for Men (SHIM) scores showed no differences if the men in the study were treated with testosterone 25 mg a day (AndroGel), testosterone 50 mg a day, or placebo, said researchers from the University of Colorado in Denver. The SHIM scale ranges from 1-25, with a score of 1-7 reflecting severe erectile dysfunction and a score of 22-25 indicating no erectile dysfunction. The study participants were about 65-years-old and had a body mass index of about 29 kg/m2. More 90% were Caucasian.
In oral presentations at the annual meeting of the American Society for Reproductive Medicine, that men did experience an increase in testosterone levels at six months and one year for both the low-dose and high-dose treatment when compared with baseline levels. But that change did not translate into better sexual improvement for the men:
- Among the 56 placebo patients, the baseline SHIM score was 15.9; at six months it was 16.3 and at one year it was 16.9 (P=0.70 from baseline)
- Among the 56 men who were assigned to testosterone 25 mg, the baseline SHIM score was 16.1; at sic months the score was 16.2; and at one year the score was 16.1 (P=0.84)
- Among the 55 men who were assigned to testosterone 50 mg, the baseline SHIN score was 15.9; at six months the score was 16.1; and at one year the score was 17.9 (P=0.54)
At baseline, testosterone levels were 294.3 ng/dL among the placebo patients, and by the end of the study, testosterone levels averaged 283.9 ng/dL (P=0.28). The patients taking testosterone 25 mg started with a level of 292.1 ng/dL and that increased to 456.8 ng/dL at one year (P<0.01). The men receiving 50 mg testosterone began with an average level of 303.5 ng/dL and that increased significantly to 595.3 ng/dL (P<0.01).
“Transdermal testosterone did improve testosterone levels to a normal range,” researchers said. “But SHIM scores did not improve, while men in the study did not take other erectile dysfunction medications.”
Erectile dysfunction is not just a problem of low testosterone, said Edward Kim, MD, from the University of Tennessee Graduate School of Medicine in Knoxville. “I find it amazing that men with diabetes, high blood pressure, high cholesterol and other factors that impact erectile function will perceive that it is low testosterone that is causing their erectile dysfunction,” said Kim, who is president of the Society of Male Reproduction and Urology. “In my practice, I find that maybe 10% to 15% of men with erectile dysfunction can be helped with testosterone supplementation, so the results of this study by the Colorado group is not surprising to me.”
Source: medpagetoday