Although decline in sexual function is a common reason for ageing men to seek advice regarding testosterone therapy, placebo-controlled trial data have been unable to show a consistent, beneficial role for testosterone. The objective of this study was to determine the effect of testosterone therapy on sexual function in non-obese ageing men with symptoms of androgen deficiency and low–normal serum testosterone levels. A total of 60 men aged 55 years or older in good general health with total testosterone (TT) levels <15 nM, and with symptoms suggestive of androgen deficiency, were randomized in a double-blinded protocol to transdermal testosterone patches or placebo for 12 months. Sexual function was assessed using the International Index of Erectile Function at weeks 0, 26 and 52. In men receiving testosterone TT levels increased by 30% (P=0.01) and luteinizing hormone decreased by 50% (P<0.001). Relative to placebo, testosterone therapy improved sexual desire (P=0.04); however other parameters of sexual function including erectile function were unaffected by the treatment. Ageing men in good general health and with symptoms of androgen deficiency and low–normal serum testosterone levels receiving 12 months of transdermal testosterone therapy experienced, relative to placebo, improved sexual desire but no effect on other parameters of sexual function.
This is a preview of subscription content, access via your institution
Subscribe to Journal
Get full journal access for 1 year
only $14.88 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Allan CA, McLachlan RI . Age-related changes in testosterone and the role of replacement therapy in older men. Clin Endocrinol (Oxf) 2004; 60: 653–670.
Brill KT, Weltman AL, Gentili A, Patrie JT, Fryburg DA, Hanks JB et al. Single and combined effects of growth hormone and testosterone administration on measures of body composition, physical performance, mood, sexual function, bone turnover, and muscle gene expression in healthy older men. J Clin Endocrinol Metab 2002; 87: 5649–5657.
Isidori AM, Giannetta E, Gianfrilli D, Greco EA, Bonifacio V, Aversa A et al. Effects of testosterone on sexual function in men: results of a meta-analysis. Clin Endocrinol (Oxf) 2005; 63: 381–394.
Snyder PJ, Peachey H, Hannoush P, Berlin JA, Loh L, Lenrow DA et al. Effect of testosterone treatment on body composition and muscle strength in men over 65 years of age. J Clin Endocrinol Metab 1999; 84: 2647–2653.
Steidle C, Schwartz S, Jacoby K, Sebree T, Smith T, Bachand R . AA2500 testosterone gel normalizes androgen levels in aging males with improvements in body composition and sexual function. J Clin Endocrinol Metab 2003; 88: 2673–2681.
Davidson JM, Chen JJ, Crapo L, Gray GD, Greenleaf WJ, Catania JA . Hormonal changes and sexual function in aging men. J Clin Endocrinol Metab 1983; 57: 71–77.
Korenman SG, Morley JE, Mooradian AD, Davis SS, Kaiser FE, Silver AJ et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab 1990; 71: 963–969.
Vermeulen A . Androgen replacement therapy in the aging male—a critical evaluation. J Clin Endocrinol Metab 2001; 86: 2380–2390.
Zitzmann M, Faber S, Nieschlag E . Association of specific symptoms and metabolic risks with serum testosterone in older men. J Clin Endocrinol Metab 2006; 91: 4335–4343.
Buena F, Swerdloff RS, Steiner BS, Lutchmansingh P, Peterson MA, Pandian MR et al. Sexual function does not change when serum testosterone levels are pharmacologically varied within the normal male range. Fertil Steril 1993; 59: 1118–1123.
Korenman SG . Epidemiology of erectile dysfunction. Endocrine 2004; 23: 87–91.
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB . Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Kunelius P, Lukkarinen O, Hannuksela ML, Itkonen O, Tapanainen JS . The effects of transdermal dihydrotestosterone in the aging male: a prospective, randomized, double blind study. J Clin Endocrinol Metab 2002; 87: 1467–1472.
Wittert GA, Chapman IM, Haren MT, Mackintosh S, Coates P, Morley JE . Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low–normal gonadal status. J Gerontol A Biol Sci Med Sci 2003; 58: 618–625.
Leifke E, Gorenoi V, Wichers C, Von Zur Muhlen A, Von Buren E, Brabant G . Age-related changes of serum sex hormones, insulin-like growth factor-1 and sex-hormone binding globulin levels in men: cross-sectional data from a healthy male cohort. Clin Endocrinol (Oxf) 2000; 53: 689–695.
Tenover JL . Male hormone replacement therapy including ‘andropause’. Endocrinol Metab Clin North Am 1998; 27: 969–987, x.
Tremblay RR, Morales A . Canadian practice recommendations for screening, monitoring and treating men affected by andropause or partial androgen deficiency. Aging Male 1998; 1: 1368–5538.
Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A . The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.
Rosen RC, Cappelleri JC, Gendrano III N . The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res 2002; 14: 226–244.
Allan CA, Strauss BJ, Burger HG, Forbes EA, McLachlan RI . Testosterone therapy prevents gain in visceral adipose tissue and loss of skeletal muscle in nonobese aging men. J Clin Endocrinol Metab 2008; 93: 139–146.
Hayes FJ . Testosterone—fountain of youth or drug of abuse? J Clin Endocrinol Metab 2000; 85: 3020–3023.
Snyder PJ, Peachey H, Berlin JA, Hannoush P, Haddad G, Dlewati A et al. Effects of testosterone replacement in hypogonadal men. J Clin Endocrinol Metab 2000; 85: 2670–2677.
Jain P, Rademaker AW, McVary KT . Testosterone supplementation for erectile dysfunction: results of a meta-analysis. J Urol 2000; 164: 371–375.
Gray PB, Singh AB, Woodhouse LJ, Storer TW, Casaburi R, Dzekov J et al. Dose-dependent effects of testosterone on sexual function, mood, and visuospatial cognition in older men. J Clin Endocrinol Metab 2005; 90: 3838–3846.
Allan CA, Strauss BJ, Burger HG, Forbes EA, McLachlan RI . The association between obesity and the diagnosis of androgen deficiency in symptomatic ageing men. Med J Aust 2006; 185: 424–427.
Watson Laboratories Inc. (Salt Lake City, UT, USA) supplied the study medication and Professor Mark Frydenberg provided urological opinion. Professor Henry Burger provided expert advice regarding study design and analysis. Associate Professor Damien Jolley, senior biostatistician, Monash Institute of Health Services Research, provided statistical assistance. We thank the study subjects for their dedicated participation. Dr Allan received an Australian Postgraduate Award 2000 (Monash University, no. 10506136) and an NHMRC Medical Postgraduate Research Scholarship 2001–2004 (no. 169015). Professor McLachlan is a principal research fellow, NHMRC (no. 441103). This work was supported by Mayne Pharma Australia Pty Ltd.
About this article
Cite this article
Allan, C., Forbes, E., Strauss, B. et al. Testosterone therapy increases sexual desire in ageing men with low–normal testosterone levels and symptoms of androgen deficiency. Int J Impot Res 20, 396–401 (2008). https://doi.org/10.1038/ijir.2008.22
- sexual function
This article is cited by
Neural activation-based sexual orientation and its correlation with free testosterone level in postoperative female-to-male transsexuals: preliminary study with 3.0-T fMRI
Surgical and Radiologic Anatomy (2016)
Current Atherosclerosis Reports (2015)
Effects of testosterone on lean mass gain in elderly men: systematic review with meta-analysis of controlled and randomized studies
Waist-to-height ratio as a predictor of serum testosterone in ageing men with symptoms of androgen deficiency
Asian Journal of Andrology (2011)
International Journal of Impotence Research (2009)