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Testosterone replacement therapy and erectile dysfunction

International Journal of Impotence Research volume 34, pages 698–703 (2022)Cite this article

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Abstract

Testosterone (T) deficiency and erectile dysfunction (ED) are independently functionally and socially impairing, and their concurrence in men can be challenging to treat. Successful management requires an understanding of the mechanisms through which T underlies normal erectile function. While the literature elucidating some of these mechanisms is vast (e.g., androgen regulation of the activity of nitric oxygen synthase and phosphodiesterase type 5) for others it is scarce (e.g., catalysts of castration-induced corporal fibrosis). The randomized controlled trial data for the efficacy of T replacement as mono- or combination therapy to treat ED has been conflicting. Positive results were frequently not clinically meaningful. Meta-analyses have been helpful in illuminating trends that seem to be promising. Consensus is still lacking in several areas, such as the threshold of low T severity for which replacement therapy is most beneficial; the timing for initiating combination therapy; and the duration of treatment.

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  1. Department of Urology, University of California, Davis, Sacramento, CA, USA

    Ifeanyi C. Onyeji & Raul I. Clavijo

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I.O. was responsible for conducting the search, compiling the eligible studies, interpreting the studies, writing the manuscript, creating the tables, and organizing the reference lists. R.C. was responsible for outlining the sections of the report, interpreting the studies, editing, and providing feedback on the report.

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Correspondence to Raul I. Clavijo.

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Onyeji, I.C., Clavijo, R.I. Testosterone replacement therapy and erectile dysfunction. Int J Impot Res 34, 698–703 (2022). https://doi.org/10.1038/s41443-021-00512-w

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