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Men with severe hypogonadism reported improved sexual function after testosterone replacement therapy with Nebido, study results show.

However, sexual function scores for men with mild hypogonadism were mostly unchanged after therapy. The researchers recommend at least 30 weeks of treatment before evaluation of improvement in erectile dysfunction.

“By mixing mild and severe hypogonadism cohorts, previous investigators may have underestimated the potential benefits of testosterone supplementation on sexual function. The benefits in sexual function were still increasing at 30 weeks suggesting that trials of testosterone therapy need to be continued for at least 6 months,” Geoffrey Hackett, MD, FRCPI, MRCGP, a consultant in sexual medicine at Good Hope Hospital in the United Kingdom, told Endocrine Today.

After 30 weeks, compare with baseline, erectile function, intercourse satisfaction and sexual desire scores increased in the severe hypogonadism testosterone treatment group (P = .038, P = .0035 and P = .0001, respectively). Intercourse satisfaction decreased in the severe hypogonadism placebo group.

It could be said that testosterone is what makes men, men. It gives them their characteristic deep voices, large muscles, and facial and body hair, distinguishing them from women. It stimulates the growth of the genitals at puberty, plays a role in sperm production, fuels libido, and contributes to normal erections. It also fosters the production of red blood cells, boosts mood, and aids cognition.

Over time, the testicular “machinery” that makes testosterone gradually becomes less effective, and testosterone levels start to fall, by about 1% a year, beginning in the 40s. As men get into their 50s, 60s, and beyond, they may start to have signs and symptoms of low testosterone such as lower sex drive and sense of vitality, erectile dysfunction, decreased energy, reduced muscle mass and bone density, and anemia. Taken together, these signs and symptoms are often called hypogonadism (“hypo” meaning low functioning and “gonadism” referring to the testicles). Researchers estimate that the condition affects anywhere from two to six million men in the United States. Yet it is an underdiagnosed problem, with only about 5% of those affected receiving treatment.

Studies have shown that testosterone-replacement therapy may offer a wide range of benefits for men with hypogonadism, including improved libido, mood, cognition, muscle mass, bone density, and red blood cell production. But little consensus exists on what constitutes low testosterone, when testosterone supplementation makes sense, or what risks patients face. Much of the current debate focuses on the long-held belief that testosterone may stimulate prostate cancer.