Moderate effect of testosterone on sexual function and no effect on physical function

Testosterone therapy for men, 65 and older with low testosterone levels and testosterone-related deficiency symptoms yielded only modest effects on sexual function and no effect on the vitality and physical function in the new study. In a recent article in The New England Journal of Medicine reported partial data for the National Institutes of Health-funded study Testosterone Trials, which includes seven independent interconnected studies (sexual function, vitality, physical ability, cognitive function, effect on hematopoiesis, bone density and cardiovascular effect). Of the 51,085 men who were asked to meet 790 (1.5 percent), the criteria for inclusion. The criteria were: age 65 and older, serum testosterone less than 9.5 nmol / L and symptoms of testosterone deficiency in the form of either: •reduced physical capacityrn•decreased sexual functionrn•decreased vitality. Prostate cancer and severe heart failure were exclusion criteria.rnTestosterone substitution did not improve the physical capacity of the older men who participated in the study (p = 0.20). Regarding vitality was seen also no significant difference between the placebo and the testosterone-treated men. The effect on sexual function was moderate, of dubious clinical relevance, and not as good as conventional treatment with PDE5 inhibitors in single therapy (such as Sildenafil and Tadalafil) in erectile dysfunction. The questionnaire psychosexual daily questionnaire, the PDQ-Q4, was used to estimate the sexual function. The testosterone-treated had about 0.3 point increase on a twelve point scale after twelve months of treatment (p <0.001). The average age in the study was 72 years. The majority were obese (BMI 31 kg / m 2 ), over 36 percent of the participants had diabetes, 70 percent treated for hypertension and about 20 percent were sleep apnea syndrome. The study was double-blind, placebo-controlled treatment and twelve months. The group receiving testosterone replacement achieved testosterone values corresponding to normal values for men 19-40 years of age. Do not respond to cardiovascular risk with testosteron tabletter The study was sadly underpowered to answer whether the risk of cardiovascular disease was increased in those receiving testosterone replacement with testosteron tabletter. Previous studies have shown a relationship and it is still a controversial subject where randomized studies with sufficient power is needed to clarify this uncertainty. Testosterone therapy for older men is controversial and still no larger prospective randomized studies of cardiovascular safety, and to some extent also on the risk of prostate cancer in the aged man. Before these data are available, it will be difficult to medically justify the use of testosterone replacement in elderly men for the treatment of sexual dysfunction or for the optimization of physical and mental capacity, nor this study, with the selection criteria used, provide scientific support. Michael Lehtihet , PhD, Senior Assistant, Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, a member of the Stockholm County drug expert committee for endocrine and metabolic diseases.