Testosterone and erectile function: From basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction

Traish, Abdulmaged M.; Goldstein, Irwin; Kim, Noel N.

doi:10.1016/j.eururo.2007.02.034

Cited by 268Hormonal and reproductive studiesSexual function and dysfunction studiesUrological Disorders and Treatments

Testosterone and erectile function: From basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction

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Traish, Abdulmaged M., Goldstein, Irwin, Kim, Noel N.·2007·European Urology

DOI 10.1016/j.eururo.2007.02.034PMC PMC2562639

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Abstract

Objectives Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology.Methods A literature review was performed utilizing the US National Library of Medicine's PubMed database.Results On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgen-dependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction.Conclusions The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns.

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Androgens regulate erectile physiology via multiple mechanisms.
“Androgens regulate erectile physiology via multiple mechanisms [37].”
From Erectile dysfunction and its pharmacology: An overview (2017) · cites this paper as [37]
Estradiol, dihydrotestosterone, and 3-alpha androstanediol have established roles in reproductive, bone, hepatic, renal, cardiovascular, dermatologic, prostatic, penile, and central nervous system functions.
“Estradiol, DHT, and the DHT product, 3-alpha androstanediol have established roles in reproductive, bone, hepatic, renal, cardiovascular, dermatologic, prostatic, penile, and central nervous system functions, among others.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [19]

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Long-term Oral Administration of 5α-reductase Inhibitor Attenuates Erectile Function by Inhibiting Autophagy and Promoting Apoptosis of Smooth Muscle Cells in Corpus Cavernosum of Aged Rats
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High efficacy, rapid onset nanobiolosomes of sildenafil as a topical therapy for erectile dysfunction in aged rats
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Testosterone positively regulates functional responses and nitric oxide expression in the isolated human corpus cavernosum
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Role of Glucose-Lowering Medications in Erectile Dysfunction
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Authors: Traish, A. M., Goldstein, I., & Kim, N. N.
Affiliations: Boston University (US)
Corresponding author: Traish, Abdulmaged M.
ORCID: Traish, Abdulmaged M.
Goldstein, Irwin
Kim, Noel N.
Venue: European Urology
Publisher: Elsevier BV
Published: 2007-07
Volume: 52
Issue: 1
Pages: 54-70
ISSN: 0302-2838 (ISSN-L)
DOI: 10.1016/j.eururo.2007.02.034
PMC: PMC2562639
OpenAlex: W2074489144
Cited by: 268
References: 184
Citations by year: 2026: 6 · 2025: 9 · 2024: 6 · 2023: 12 · 2022: 16 · 2021: 16 · 2020: 10 · 2019: 11 · 2018: 10 · 2017: 9 · 2016: 28 · 2015: 12 · 2014: 11 · 2013: 14 · 2012: 9
FWCI: 3.11
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: European Urology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Diabetes and Digestive and Kidney Diseases (DK 56846, DK02696, K01DK002696, R01DK056846)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Urology › Urological Disorders and Treatments
Keywords: testosterone, erectile dysfunction, androgen deficiency, erectile physiology, penile tissue, testosterone replacement therapy, male sexual health
MeSH terms: Androgens, Animals, Humans, Hypogonadism, Erectile Dysfunction, Male, Penile Erection, Testosterone

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Testosterone and erectile function: From basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction

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