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Cited by 263Hormonal and reproductive studiesSexual function and dysfunction studiesSperm and Testicular Function

Testosterone supplementation and sexual function: A meta-analysis study

Open access
Corona, Giovanni, Isidori, Andrea M., Buvat, Jaques, Aversa, Antonio, Rastrelli, Giulia, Hackett, Geoff, Rochira, Vincenzo, Sforza, Alessandra +3 more·2014·The Journal of Sexual Medicine
DOI 10.1111/jsm.12536
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Abstract

Introduction: The role of testosterone supplementation (TS) as a treatment for male sexual dysfunction remains questionable. Aim: The aim of this study was to attempt a meta-analysis on the effect of TS on male sexual function and its synergism with the use of phosphodiesterase type 5 inhibitor (PDE5i). Methods: An extensive Medline, Embase, and Cochrane search was performed. Main Outcome Measures: All randomized controlled trials (RCTs) comparing the effect of TS vs. placebo or the effect of TS as add on to PDE5is on sexual function were included. Data extraction was performed independently by two of the authors (A. M. Isidori and G. Corona), and conflicts resolved by the third investigator (M. Maggi). Results: Out of 1,702 retrieved articles, 41 were included in the study. In particular, 29 compared TS vs. placebo, whereas 12 trials evaluated the effect of TS as add on to PDE5is. TS is able to significantly ameliorate erectile function and to improve other aspects of male sexual response in hypogonadal patients. However, the presence of possible publication bias was detected. After applying “trim and fill” method, the positive effect of TS on erectile function and libido components retained significance only in RCTs partially or completely supported by pharmaceutical companies (confidence interval [0.04–0.53] and [0.12; 0.52], respectively). In addition, we also report that TS could be associated with an improvement in PDE5i outcome. These results were not confirmed in placebo-controlled studies. The majority of studies, however, included mixed eugonadal/hypogonadal subjects, thus imparting uncertainty to the statistical analyses. Conclusions: TS plays positive effects on male sexual function in hypogonadal subjects. The role of TS is uncertain in men who are not clearly hypogonadal. The apparent difference between industry-supported and independent studies could depend on trial design more than on publication bias. New RCTs exploring the effect of TS in selected cases of PDE5i failure that persistently retain low testosterone levels are advisable.

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Crossref · 10.1111/jsm.12536

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Authors
Corona, G., Isidori, A. M., Buvat, J., Aversa, A., Rastrelli, G., Hackett, G., Rochira, V., Sforza, A., Lenzi, A., Mannucci, E., & Maggi, M.
Affiliations
  • Azienda USL di Bologna (IT)
  • Sapienza University of Rome (IT)
  • Centre ETPARP , Lille , France
  • Department of Experimental Medicine   , Rome , Italy
  • University of Florence (IT)
  • Good Hope Hospital , Sutton Coldfield , UK
  • University of Modena and Reggio Emilia (IT)
  • Azienda Ospedaliero-Universitaria Careggi (IT)
Corresponding author
Maggi, Mario
ORCID
Venue
The Journal of Sexual Medicine
Publisher
Oxford University Press (OUP)
Published
2014-06-01
Volume
11
Issue
6
Pages
1577-1592
ISSN
  • 1743-6095 (ISSN-L)
  • 1743-6109
DOI
10.1111/jsm.12536
OpenAlex
W1753661430
Cited by
263
References
84
Citations by year
2026: 10 · 2025: 12 · 2024: 12 · 2023: 10 · 2022: 20 · 2021: 19 · 2020: 15 · 2019: 24 · 2018: 28 · 2017: 28 · 2016: 38 · 2015: 29 · 2014: 14
FWCI
5.77
Type
journal article
Language
en
Open access
Licence
Locations
  • The Journal of Sexual Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion)
  • IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, cc-by)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
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 › Reproductive Medicine › Sperm and Testicular Function
Keywords
testosterone supplementation, male sexual dysfunction, erectile function, sexual desire, hypogonadism, phosphodiesterase-5 inhibitors, combination therapy, publication bias
MeSH terms
Adult, Androgens, Combined Modality Therapy, Humans, Libido, Male, Penile Erection, Sexual Behavior, Sexual Dysfunction, Physiological, Testosterone, Randomized Controlled Trials as Topic, Dietary Supplements, Phosphodiesterase 5 Inhibitors

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