A recent meta-analysis reported that TTh (testosterone therapy) was ineffective for ED (erectile dysfunction.) This new meta-analysis comes to a different conclusion and finds testosterone therapy significantly improves erectile dysfunction and other parameters of sexual function.
Out of 137 retrieved articles, 14 were included in the study enrolling 2298 participants, with a mean follow-up of 40.1 wk and mean age of 60.2 ± 6.5 yr. Using IIEF-erectile function domain (IIEF-EFD) as the outcome, we found that TTh significantly improved erectile function compared with placebo (mean difference = 2.31 [1.41;3.22] IIEF-EFD score, p < 0.0001). Patients with more severe hypogonadism (total T < 8 nmol/l) reported greater changes in final IIEF-EFD score when compared with those with a milder T deficiency (total T < 12 nmol/l; 1.47 [0.90;2.03]and 2.95 [1.86;4.03] for total T < 12 nmol/l and <8 nmol/l, respectively, Q = 5.61, p = 0.02). The magnitude of the effect was lower in the presence of metabolic derangements, such as diabetes and obesity. Other aspects of sexual function, as evaluated by IIEF subdomains, were also improved with TTh including libido, intercourse satisfaction, orgasm, and overall sexual satisfaction.