Sexual Health Q&A

Can testosterone replacement therapy help men with erectile dysfunction (ED) and low testosterone?

The answer to this question is unclear. Some doctors do prescribe testosterone therapy when their patients have low testosterone and do not respond well to erectile dysfunction (ED) drugs like Viagra, Levitra, and Cialis. And for some men, it does help. There are studies that support this position.

In February 2016, a study in the New England Journal of Medicine reported that testosterone replacement therapy might have sexual benefits for older men. This research involved 790 men over age 65 whose testosterone levels had fallen below 275 ng/dL as a result of normal aging. The men were randomly assigned to take either testosterone or a placebo for one year. For those who received testosterone, doses were adjusted if necessary to maintain a normal range.

In general, the men on testosterone saw an increase in sexual activity when compared to the men in the placebo group. Also, men on testosterone tended to feel more sexual desire and achieve better erections.

There were no differences in the rates of cardiovascular events, such as heart attack and stroke, between the two groups. However, the researchers noted that the study was not large enough to fully evaluate any potential risks of testosterone replacement therapy.

Given the complexities surrounding this issue, men who have low testosterone and erectile dysfunction are encouraged to discuss their treatment options with their doctors.