Testosterone helps older men with low sexual desire, study shows
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When it comes to treating older men with testosterone therapy, physicians have largely been on their own. There just haven’t been any good studies.
That changed Wednesday.
Research published in the New England Journal of Medicine shows that testosterone therapy boosted the sexual activity and desire in older men with low levels and no health issues.
But the hormone replacement therapy did little to increase their physical ability or energy level.
The study included nearly 800 men aged 65 and older at dozens of academic medical centers, health care institutions and Veterans Affairs facilities from Seattle to Boston. All of them had low testosterone levels and symptoms such as low sexual desire. They also had no health issues that would mean they shouldn’t get testosterone, such as cardiovascular problems or high levels of a protein produced by the prostate.
Over a year, one group received a testosterone gel that raised their levels to that of a 19 -to 40-year-old. The others got a placebo. The men participated in trials that measured sexual function, physical ability and vitality, or energy level.
They took a quiz every three months. The questionnaires showed that men in the testosterone replacement group experienced an increase in sexual activity, desire and erectile function compared with the placebo group. They also reported an improved mood but the results were minimal, said Dr. Eric Orwoll, an endocrinologist at Oregon Health & Science University.
“It’s not like they went from sad to overwhelmingly happy,” said Orwoll, who wrote an accompanying editorial about the study.
Men reported enjoying exercise more, but the testosterone group didn’t fare better in a six-minute walking test compared to the placebo group. The testosterone therapy didn’t affect their energy level, either.
Though the results weren’t dramatic, the study did break new ground, Orwoll said.
“This is the first really well done study,” Orwoll said. “That in and of itself is really important.”
He said it will give physicians solid data to help them guide a discussion with patients about whether testosterone therapy is the right choice for them.
He cautioned that the results only apply to men who have the same characteristics as the study group. It doesn’t apply to men with normal testosterone levels.
The likely benefactors: men with low testosterone levels who have complaints about sexual function, Orwoll said.
“We know that testosterone therapy is safe for a year,” Orwoll said.
There were four cases of prostate cancer diagnosed during the study. But the group wasn’t large enough to conclude an association with the testosterone therapy, the study said. Researchers also noted that men with a high risk of developing prostate cancer were excluded along with those with moderately severe urinary tract symptoms.
More studies are needed to determine any potential long-term risks and effects, Orwoll said.
“There are a lot of other things that testosterone might have an effect on like anemia or bone strength,” Orwoll said. “There are a lot of still unanswered questions out there.”