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Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels
Open accessAbstract
CONTEXT: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function. OBJECTIVE: To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes. DESIGN: A placebo-controlled trial. SETTING: Twelve academic medical centers in the United States. PARTICIPANTS: A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month. METHODS: Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function. RESULTS: Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T. CONCLUSIONS: In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.
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“These trials and other independent studies found that T administration in elderly men resulted in improvements in sexual function,202, 203 lean body mass,204, 205 physical function,206 strength,25, 205, 207 protein synthesis,25 cholesterol,204, 205, 208 and bone density.209”
From Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications (2021) · cites this paper as [202]
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Metadata
- Authors
- Cunningham, G. R., Stephens-Shields, A. J., Rosen, R. C., Wang, C., Bhasin, S., Matsumoto, A. M., Parsons, J. K., Gill, T. M., Molitch, M. E., Farrar, J. T., Cella, D., Barrett-Connor, E., Cauley, J. A., Cifelli, D., Crandall, J. P., Ensrud, K. E., Gallagher, L., Zeldow, B., Lewis, C. E., Pahor, M., Swerdloff, R. S., Hou, X., Anton, S., Basaria, S., Diem, S. J., Tabatabaie, V., Ellenberg, S. S., & Snyder, P. J.
- Affiliations
- Baylor College of Medicine (US)
- Department of Biostatistics and Epidemiology (A.J.S.-S., J.T.F., B.Z., X.H., S.S.E.), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- New England Research Institutes (US)
- University of California, Los Angeles (US)
- Brigham and Women's Hospital (US)
- University of Washington (US)
- University of California San Diego (US)
- Yale University (US)
- Division of Endocrinology, Metabolism, and Molecular Medicine (M.E.M.), Chicago, Illinois 60611
- University of Pennsylvania (US)
- Northwestern University (US)
- University of Pittsburgh (US)
- Albert Einstein College of Medicine (US)
- Minneapolis VA Health Care System (US)
- University of Alabama at Birmingham (US)
- University of Florida (US)
- University of Minnesota (US)
- Corresponding author
- Cunningham, Glenn R.
- ORCID
- Cunningham, Glenn R.
- Wang, Christina
- Bhasin, Shalender
- Matsumoto, Alvin M.
- Parsons, J. Kellogg
- Gill, Thomas M.
- Molitch, Mark E.
- Farrar, John T.
- Cella, David
- Barrett-Connor, Elizabeth
- Cauley, Jane A.
- Crandall, Jill P.
- Ensrud, Kristine E.
- Zeldow, Bret
- Lewis, Cora E.
- Swerdloff, Ronald S.
- Hou, Xiaoling
- Anton, Stephen
- Basaria, Shehzad
- Diem, Susan J.
- Tabatabaie, Vafa
- Ellenberg, Susan S.
- Snyder, Peter J.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2016-08-01
- Volume
- 101
- Issue
- 8
- Pages
- 3096-3104
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC4971331
- OpenAlex
- W2464449413
- Cited by
- 162
- References
- 45
- Citations by year
- 2026: 10 · 2025: 21 · 2024: 17 · 2023: 17 · 2022: 19 · 2021: 12 · 2020: 10 · 2019: 16 · 2018: 21 · 2017: 14 · 2016: 5
- FWCI
- 18.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pennsylvania
- National Institutes of Health (UL1TR000124, 5p60dk079626-05, UL1TR000142)
- National Institute on Aging (U01AG030644, K24AG021507, P30AG021342)
- National Institute of Diabetes and Digestive and Kidney Diseases (P60-DK-079626, P30DK079626)
- National Institute of Child Health and Human Development
- National Center for Advancing Translational Sciences
- 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 replacement therapy, androgen deficiency, older men, sexual function, sexual desire, sexual activity, erectile function, estradiol, testosterone gel
- MeSH terms
- Aged, Humans, Erectile Dysfunction, Libido, Male, Placebos, Surveys and Questionnaires, Sexual Behavior, Sexual Dysfunction, Physiological, Testosterone, Treatment Outcome, Hormone Replacement Therapy
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