Testosterone and Sexual Function

Adriane Fugh-Berman; Anthony R. Scialli

Disclosures

Curr Opin Urol. 2017;27(6):516-518. 

In This Article

Abstract and Introduction

Abstract

Purpose of review: Testosterone therapy has been advocated in the treatment of symptoms that may represent normal aging. We briefly review randomized clinical trials on the effects of testosterone therapy on sexual function.

Recent findings: About half of clinical trials showed no benefit of testosterone therapy on any aspect of sexual function. In those studies showing a benefit on some aspect of sexual function, most sexual function domains were not improved. Testosterone therapy has been disappointing in the treatment of erectile dysfunction. Potential risks of therapy include an increase in thromboembolic and other cardiovascular diseases.

Summary: The limited and inconsistent benefits of testosterone therapy for sexual function argue against use of this therapy in aging men, including those with 'low testosterone'.

Introduction

The hope that testosterone treatment could combat symptoms of aging is rapidly fading. The reluctantly aging have always been a profitable market. In the 1920s, implanting testicle slices from animals or executed prisoners into scrotal sacs was briefly popular.[1] Of course, those grafts would not have survived, but the procedure thrived for a while, fueled by pictures of rejuvenated men. Testosterone patches, gels, and injections are the modern version of testicular implants, marketed as youth-restoring tonics. The market for testosterone took off after topical gel formulations became available. AndroGel (Abbvie, North Chicago, IL) sales exceeded $1.1 billion in 2012 but then fell after the food and drug administration revised the labeling and lawsuits over adverse effects emerged; in 2016, AndroGel sales were $675 million.[2] Testosterone lawsuits have been consolidated in multidistrict litigation, and the first cases were scheduled to go to court in summer 2017.

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