Whether erectile dysfunction improves with testosterone replacement has been the subject of a study published July 2017 (Ref. 1). It was a prospective study involving 656 men at an average age of 60.7 years. These men all had low testosterone levels and also symptoms of deficiency of testosterone. The most prominent symptom was erectile dysfunction. 360 of these men received regular treatment with testosterone for up to 10 years. The remainder of the men who decided no to have testosterone replacement was the control group. Physicians examined both groups at least twice per year.
The assessment of all the patients was according to the international prostate symptom score. In the beginning of the study the percentage for all of the men in the study without erectile dysfunction was only 17.1%. At the end of the study 74.4% of the group that had testosterone treatment showed no erectile dysfunction.
Is testosterone replacement safe?
The medical literature is often questioning the safety of long-term replacement in men who initially are testosterone deficient. In the past it was the theory that the administration of testosterone might cause prostate cancer. The other concern was whether or not testosterone would cause heart attacks.
This is why researchers in a study from August 2017 decided to look for both of these criteria, prostate cancer and heart attacks. The study showed, first of all, that there is no cardiovascular risk and no risk of prostate cancer with testosterone hormone replacement. In this metaanalysis that looked at more than 50 studies, testosterone replacement did not cause any complications. Furthermore, there were no cases of heart arrhythmias, strokes, heart failure, cardiovascular deaths, acute coronary syndrome or coronary by-pass surgery.
In addition, there also was not a single case of prostate cancer that would have been caused by testosterone replacement.
The main symptom of lack of testosterone in aging men is the loss of erections (erectile dysfunction). In the first study cited in this review only 17.1% were without erectile dysfunction. But testosterone replacement was able to increase the number of those with no erectile dysfunction to 74.4% of the men. In contrast those who were the controls, who did not go on testosterone replacement, deteriorated even more with regard to erectile dysfunction and with regard to voiding functions.
The second study revealed from a metaanalysis that testosterone replacement is safe. It does not cause cardiovascular disease and does not cause prostate cancer. In conclusion, every older man with documented low testosterone levels should get testosterone replacement. I am one of these men to whom this applies. In order to keep the blood levels within the normal range, I am going for 3-monthly testosterone blood tests. It is also important to mention that normal testosterone levels in men are not only important for erections. It is not all about sex! Testosterone is also important for heart health in aging males as well as for cognitive function.
“Testosterone Replacement Therapy Improves Sexual Function”, cited by Life Extension magazine, March 2018 as J. Urol., July 18, 2017.