Testosterone replacement does not improve ejaculatory dysfunction

Nelson Vergel

Founder, ExcelMale.com
J Clin Endocrinol Metab. 2015 Jul 9:jc20144434. [Epub ahead of print]

Testosterone Replacement in Androgen-Deficient Men With Ejaculatory Dysfunction: A Randomized Controlled Trial.

Paduch DA1, Polzer PK1, Ni X1, Basaria S1.



Abstract

CONTEXT:

Low T levels have been associated with ejaculatory dysfunction (EjD) in cross-sectional studies; however, the efficacy of T replacement in improving EjD has not been studied in a randomized controlled trial.

OBJECTIVE:
To evaluate the efficacy of T replacement in androgen-deficient men with EjD.

DESIGN:
A multicenter, double-blind, randomized, placebo-controlled, 16-week trial with T solution 2% versus placebo.

SETTING:
Medical centers in the United States, Canada, and Mexico.

PATIENTS OR OTHER PARTICIPANTS:
Seventy-six men with one or more EjD symptoms, including delayed ejaculation, anejaculation, reduced ejaculate volume, and/or reduced force of ejaculation, and two total T levels <300 ng/dL (<10.41 nmol/L) measured with liquid chromatography tandem mass spectrometry.

INTERVENTIONS:
Sixty milligrams of T solution 2% or placebo applied to the axillae for 16 weeks.

MAIN OUTCOME MEASURES:
The primary outcome was a change in the score of the three-item Male Sexual Health Questionnaire-Ejaculatory Dysfunction-Short Form (MSHQ-EjD-SF); secondary outcomes included measured ejaculate volume, scores of the bother/satisfaction item of the MSHQ-EjD-SF, the orgasmic function domain of the International Index of Erectile Function Questionnaire, and the sexual activity log.

RESULTS:
Seventy-six participants were randomized; 66 completed the study. Baseline demographic and clinical characteristics were comparable between the treatment arms. T replacement improved the MSHQ-EjD-SF score (mean score change, +3.1); however, this effect was not statistically different from placebo (mean score change, +2.5; P = .596). No differences were seen in any of the secondary outcomes or frequency of adverse events.

CONCLUSION:
T replacement was not associated with significant improvement in EjD in androgen-deficient men.
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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