Men with very low testosterone may see improvements in sexual function with testosterone replacement therapy (TRT), according to a recent review of medical studies.
Experts note that TRT may improve erections in men with very low testosterone levels. However, TRT is not a standard treatment for erectile dysfunction (ED).
After analyzing studies involving both animal and human subjects, researchers got a better understanding of how testosterone affects male sexuality and more specifics on how TRT may help.
Produced by two glands called the testes (testicles), testosterone is sometimes referred to as a “male” hormone because it plays such a large role in masculinity. (Women’s bodies make testosterone, too, but in smaller amounts.) Characteristics like facial hair, muscle mass, and a deeper voice are all driven by testosterone. The hormone is important for a man’s sex drive and erections, too.
Sometimes, men’s bodies don’t produce enough testosterone because of problems with the testes themselves or with areas of the brain that trigger testosterone production. This is called hypogonadism. Men in this situation may undergo testosterone replacement therapy in the form of gels, patches, and injections. In March 2019, the U.S. Food and Drug Administration (FDA) approved a pill form of TRT for certain hypogonadal men.
The researchers explained that a man’s hormonal system “plays a pivotal role in regulating all the steps involved in sexual activity,” from desire to arousal to orgasm. However, they noted that other factors, such as relationship and psychological issues, can affect the sexual response cycle, too.
TRT can still benefit the sex lives of hypogonadal men in several ways, they reported. Consulted studies suggested that TRT can improve desire, erections (only in cases of very low testosterone), and sexual satisfaction. It was not clear whether TRT improved orgasms.
That said, TRT might not be as successful in men with other health conditions that contribute to sexual problems, such as obesity and diabetes, they said.
The authors added that TRT might have more sexual benefits for men whose testosterone levels fall under the hypogonadism benchmark – a total testosterone measurement below 12 nmol/L. Men with higher testosterone levels might not have as much success.
Men with mild ED might experience better erections with TRT, but men with more severe ED may need a combination of TRT and other medications, the researchers reported.
Men’s testosterone levels naturally decline as they get older, too. Can TRT help these men? The answer is unclear. “The role of TRT in aging men is conflicting,” the authors said.
The article was published online in February 2019 in Sexual Medicine Reviews.
Sexual Medicine Reviews
Rastrelli, Giulia, MD, PhD, et al.
“Testosterone Replacement Therapy for Sexual Symptoms”
(Full-text. Published online: February 22, 2019)