Men being treated for erectile dysfunction do not enjoy an additional boost to their treatment by the addition of testosterone gel
A recent study suggests that the addition of testosterone gel to Viagra intake do not really benefit men in the area of erectile dysfunction and low testosterone.
The first choice and standard prescription treatments for erectile dysfunction are a group of drugs called PDE5 inhibitors; these include sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis).
For erection to occur, strong blood flow and oxygen are needed. These group of PDE5 drugs work by helping the smooth muscles of the penis to relax, which action increases blood flow, and therefore, increased oxygen.
In the cases of men who suffer from erectile dysfunction and who also suffer from low testosterone levels, physicians often prescribe testosterone gel in addition to a standard PDE5 drug.
However, new clinical trials indicated that this combination prescription is questionable,
Dr. Matthew Spitzer, lead researcher and fellow of endrocrinology at Boston University School of Medicine had this to say: “We had expected to see some added benefit from testosterone…But that’s not what we observed.”
Over a 14-week period,140 men who were randomly assigned to the duo Viagra-testosterone get intake did not fare better than those who were given Viagra and a hormone-free placebo gel.
According to Dr. Spitzer, both groups of men responded to the drug, Viagra. He said that on average, the men’s scores on a questionnaire on erectile dysfunction increased about 8 points, indicating that they ‘improved’, moving slightly up to the ‘mild’ erectile-dysfunction category.
However, there was no substantial difference between those men who used the testosterone gel and those who used the placebo.
These findings, (Nov 20, issue of the journal Annals of Internal Medicine) very much surprised the research team.
Dr. Spitzer concluded that these results are good news for men who suffer from both erectile dysfunction and low testosterone in that they suggest that a PDE5 drug alone works just as well.
According to another expert researcher, this study, has clinical implications.
Dr. Alvin Matsumoto who is an endrocrinologist (who studies the effects of testosterone throughout the body) from the University of Washington School of Medicine, Seattle, although not involved in this study, said that the findings are “likely to change the routine use of testosterone in these men.”
Dr. Matsumoto adds that this doesn’t mean that testosterone is of no use to men with erectile dysfunction, far from that.
Some men are diagnosed with hypogonadism, a medical condition indicating a deficiency in testosterone. According to Dr. Matsumoto, this diagnosis should be based on more than just the level of testosterone in a man’s blood, which, Dr Matsumoto said, should be measure more than once. Why? A “low” often turns out to be normal on a second test. In addition, the diagnosis should also be based on other possible signs and symptoms, not just erectile dysfunction, but also on problems like fatigue, depression, waning muscles and low bone mass.
The subjects of this clinical test were men aged between 40 and 70. They were assessed only for erectile dysfunction and not other symptoms, said Dr. Spitzer. Therefore, it is not clear whether the results would also apply to men diagnosed with hypogonadism.
Dr. Matsumoto added, “If you have low testosterone, but (erectile dysfunction) is the only thing that’s going on, it’s reasonable to try sildenafil alone.”
A further point, Dr. Matsumoto said, is whether the addition of testosterone therapy can be of aid to some men suffering from low testosterone levels, those who fail to get a good outcome from Viagra or another erectile dysfunction drug.
In this test, all of the 140 men started with only Viagra for a few weeks. Any man who failed to respond to the drug had his dosage increased to a maximum of 100 milligrams per day. 70 men were randomly assigned to use the testosterone gel every day for 14 weeks while the other 70 men used the placebo gel.
At the end of the study, the men in both the groups maintained the improvement they had had when they were taking only their daily dose of Viagra only.
Dr. Matsumoto concluded that this indicated the benefits of “optimizing” a man’s dosage of Viagra, and of allowing the drug sufficient time to work.
However, he added that if a man still does not obtain an improvement in his erectile function despite the use of an PDE5 drug AND his testosterone level still remains low, “my sense is that he should consider trying testosterone.”
In summary, it is controversial whether low testosterone is a medical condition that requires treatment. Pharmaceutical companies that manufacture testosterone products – costs of which can be a few hundred dollars a month – have been criticized for their attempts to promote the normal process of male aging as a medical condition, and to make money from this.
In addition, there are side effects from the use of testosterone gels: acne, prostate enlargement (that lead to embarrassing and painful urinary problems) and an increased likelihood of contracting prostate cancer are a few of these undesirable conditions, according to the Endocrine Society.