Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

What are the benefits and harms of testosterone therapy for male sexual dysfunction?—a systematic review

Abstract

The role of Testosterone Therapy (TTh) in the management of male sexual dysfunction remains unclear. Objective of the authors was to systematically review the relevant literature assessing the benefits and harms of TTh in men with sexual dysfunction. EMBASE, MEDLINE, Cochrane Systematic Reviews—Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane HTA, DARE, HEED), Google Scholar, WHO international Clinical Trials Registry Platform Search Portal, CINAHL databases and clinicaltrial.gov were searched systematically in March 2015 and an updated search was performed in March 2016. Randomized and non-randomized comparative studies assessing the benefits and harms of TTh in hypogonadal, borderline eugonadal and eugonadal men suffering from sexual dysfunction were included. Risk of bias and confounding assessments were performed. A narrative synthesis was undertaken. Of the 6410 abstracts identified, 36 studies were judged to be eligible for inclusion, including 25 randomized clinical trials (RCTs) and 11 non-randomized comparative studies (NRCSs), recruiting a total of 4944 patients. RCTs were judged to have low or unclear risk of bias, while NRCSs had high risk of bias and thus, overall quality of evidence was judged to be at least unclear. Based on the evidence mainly provided by the RCTs included in this systematic review, TTh could be considered for men with low or low-normal testosterone levels and problems with their sexual desire, erectile function and satisfaction derived from intercourse and overall sexual life. The exact testosterone formulation, dosage and duration of treatment remain to be clarified, while the safety profile of TTh also remains unclear. TTh could be used with caution in hypogonadal and most probably borderline eugonadal men to manage disorders of sexual desire, erectile function and sexual satisfaction. The overall low-to-moderate evidence quality highlights the need for robust and adequately designed clinical trials.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1
Fig. 2

References

  1. 1.

    McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, et al. Definitions of sexual dysfunctions in women and men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13:135–43. https://doi.org/10.1016/j.jsxm.2015.12.019

    Article  PubMed  Google Scholar 

  2. 2.

    Antonio L, Wu FCW, O’Neill TW, Pye SR, Ahern TB, Laurent MR, et al. Low free testosterone is associated with hypogonadal signs and symptoms in men with normal total testosterone. J Clin Endocrinol Metab. 2016;101:2647–57. https://doi.org/10.1210/jc.2015-4106

    CAS  Article  PubMed  Google Scholar 

  3. 3.

    O’Connor DB, Lee DM, Corona G, Forti G, Tajar A, O’Neill TW, et al. The relationships between sex hormones and sexual function in middle-aged and older European men. J Clin Endocrinol Metab. 2011;96:E1577–1587. https://doi.org/10.1210/jc.2010-2216

    CAS  Article  PubMed  Google Scholar 

  4. 4.

    Buvat J, Maggi M, Guay A, Torres LO. Testosterone deficiency in men: systematic review and standard operating procedures for diagnosis and treatment. J Sex Med. 2013;10:245–84. https://doi.org/10.1111/j.1743-6109.2012.02783.x

    CAS  Article  PubMed  Google Scholar 

  5. 5.

    Wu FCW, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med. 2010;363:123–35. https://doi.org/10.1056/NEJMoa0911101

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Isidori AM, Buvat J, Corona G, Goldstein I, Jannini EA, Lenzi A, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment-a systematic review. Eur Urol. 2014;65:99–112. https://doi.org/10.1016/j.eururo.2013.08.048

    CAS  Article  PubMed  Google Scholar 

  7. 7.

    Hall SA, Esche GR, Araujo AB, Travison TG, Clark RV, Williams RE, et al. Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample. J Clin Endocrinol Metab. 2008;93:3870–7. https://doi.org/10.1210/jc.2008-0021

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  8. 8.

    Grossmann M, Matsumoto AM. A perspective on middle-aged and older men with functional hypogonadism: focus on holistic management. J Clin Endocrinol Metab. 2017;102:1067–75. https://doi.org/10.1210/jc.2016-3580

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Bhasin S, Cunningham GR, Hayes FJ, Matsumoto AM, Snyder PJ, Swerdloff RS, et al. Testosterone therapy in adult men with androgen deficiency syndromes: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2006;91:1995–2010. https://doi.org/10.1210/jc.2005-2847

    CAS  Article  PubMed  Google Scholar 

  10. 10.

    Lunenfeld B, Mskhalaya G, Zitzmann M, Arver S, Kalinchenko S, Tishova Y, et al. Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men. Aging Male. 2015;18:5–15. https://doi.org/10.3109/13685538.2015.1004049

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Khera M, Adaikan G, Buvat J, Carrier S, El-Meliegy A, Hatzimouratidis K, et al. Diagnosis and treatment of testosterone deficiency: recommendations from the fourth international consultation for sexual medicine (ICSM 2015). J Sex Med. 2016;13:1787–804. https://doi.org/10.1016/j.jsxm.2016.10.009

    Article  PubMed  Google Scholar 

  12. 12.

    NIH Consensus Conference. Impotence. NIH consensus development panel on impotence. JAMA. 1993;270:83–90.

    Article  Google Scholar 

  13. 13.

    Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

    Article  Google Scholar 

  14. 14.

    Deeks JJ, Dinnes J, D’Amico R, Sowden AJ, Sakarovitch C, Song F, et al. Evaluating non-randomised intervention studies. Health Technol Assess. 2003;7:1–173.

    Article  Google Scholar 

  15. 15.

    Reeves BC, Deeks JJ, Higgins J, Wells GA Cochrane Non-Randomized Studies Methods Group. Including non-randomised studies. In: Higgins J, Green S, editors. Cochrane handbook for systematic reviews of interventions version 5.1.0. Cochrane Collaboration Web site. http://www.cochrane-handbook.org. Accessed 24 August 2017.

  16. 16.

    Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, et al. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. A Product from the ESRC Methods Programme. (Vol. 1). Bailrigg: Lancaster University; (2006). p. 1–92.

  17. 17.

    Schiavi RC, White D, Mandeli J, Levine AC. Effect of testosterone administration on sexual behavior and mood in men with erectile dysfunction. Arch Sex Behav. 1997;26:231–41.

    CAS  Article  Google Scholar 

  18. 18.

    Wagner G, Rabkin J, Rabkin R. Effects of testosterone replacement therapy on sexual interest, function, and behavior in HIV + men. J Sex Res. 1997;34:27–33. https://doi.org/10.1080/00224499709551861

    Article  Google Scholar 

  19. 19.

    Rabkin JG, Wagner GJ, Rabkin R. A double-blind, placebo-controlled trial of testosterone therapy for HIV-positive men with hypogonadal symptoms. Arch Gen Psychiatry. 2000;57:141–7. discussion155-156

    CAS  Article  Google Scholar 

  20. 20.

    Gomaa A, Eissa M, El-Gebaley A. The effect of topically applied vasoactive agents and testosterone versus testosterone in the treatment of erectile dysfunction in aged men with low sexual interest. Int J Impot Res. 2001;13:93–9. https://doi.org/10.1038/sj.ijir.3900643

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Aversa A, Isidori AM, Spera G, Lenzi A, Fabbri A. Androgens improve cavernous vasodilation and response to sildenafil in patients with erectile dysfunction. Clin Endocrinol (Oxf). 2003;58:632–8.

    CAS  Article  Google Scholar 

  22. 22.

    Boyanov MA, Boneva Z, Christov VG. Testosterone supplementation in men with type 2 diabetes, visceral obesity and partial androgen deficiency. Aging Male. 2003;6:1–7.

    CAS  Article  Google Scholar 

  23. 23.

    Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Urology. 2004;63:641–6. https://doi.org/10.1016/j.urology.2003.11.009

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Shabsigh R, Kaufman JM, Steidle C, Padma-Nathan H. Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone. J Urol. 2004;172:658–63. https://doi.org/10.1097/01.ju.0000132389.97804.d7

    CAS  Article  PubMed  Google Scholar 

  25. 25.

    Schrader S, Mills A, Scheperle M, Block JE. Improvement in sexual functioning and satisfaction in nonresponders to testosterone gel: clinical effectiveness in hypogonadal, HIV-positive males. Clin Cornerstone. 2005;7(Suppl 4):S26–31.

    Article  Google Scholar 

  26. 26.

    Shamloul R, Ghanem H, Fahmy I, El-Meleigy A, Ashoor S, Elnashaar A, et al. Testosterone therapy can enhance erectile function response to sildenafil in patients with PADAM: a pilot study. J Sex Med. 2005;2:559–64. https://doi.org/10.1111/j.1743-6109.2005.00071.x

    CAS  Article  PubMed  Google Scholar 

  27. 27.

    Steidle C, Witt MA, Matrisciano J, Block JE. Sexual functioning and satisfaction in nonresponders to testosterone gel: potential effectiveness of retreatment in hypogonadal males. Clin Cornerstone. 2005;7(Suppl 4):S20–25.

    Article  Google Scholar 

  28. 28.

    Merza Z, Blumsohn A, Mah PM, Meads DM, McKenna SP, Wylie K, et al. Double-blind placebo-controlled study of testosterone patch therapy on bone turnover in men with borderline hypogonadism. Int J Androl. 2006;29:381–91. https://doi.org/10.1111/j.1365-2605.2005.00612.x

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Rochira V, Balestrieri A, Madeo B, Granata ARM, Carani C. Sildenafil improves sleep-related erections in hypogonadal men: evidence from a randomized, placebo-controlled, crossover study of a synergic role for both testosterone and sildenafil on penile erections. J Androl. 2006;27:165–75. https://doi.org/10.2164/jandrol.05077

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Yassin AA, Saad F, Diede HE. Testosterone and erectile function in hypogonadal men unresponsive to tadalafil: results from an open-label uncontrolled study. Andrologia. 2006;38:61–8. https://doi.org/10.1111/j.1439-0272.2006.00712.x

    CAS  Article  PubMed  Google Scholar 

  31. 31.

    Richardson D, Goldmeier D, Frize G, Lamba H, De Souza C, Kocsis A, et al. Letrozole versus testosterone. a single-center pilot study of HIV-infected men who have sex with men on highly active anti-retroviral therapy (HAART) with hypoactive sexual desire disorder and raised estradiol levels. J Sex Med. 2007;4:502–8. https://doi.org/10.1111/j.1743-6109.2007.00451.x

    CAS  Article  PubMed  Google Scholar 

  32. 32.

    Morales A, Black A, Emerson L, Barkin J, Kuzmarov I, Day A. Androgens and sexual function: a placebo-controlled, randomized, double-blind study of testosterone vs. dehydroepiandrosterone in men with sexual dysfunction and androgen deficiency. Aging Male. 2009;12:104–12. https://doi.org/10.3109/13685530903294388

    CAS  Article  PubMed  Google Scholar 

  33. 33.

    Herzog AG, Farina EL, Drislane FW, Schomer DL, Smithson SD, Fowler KM, et al. A comparison of anastrozole and testosterone versus placebo and testosterone for treatment of sexual dysfunction in men with epilepsy and hypogonadism. Epilepsy Behav. 2010;17:264–71. https://doi.org/10.1016/j.yebeh.2009.12.003

    Article  PubMed  Google Scholar 

  34. 34.

    Buvat J, Montorsi F, Maggi M, Porst H, Kaipia A, Colson MH, et al. Hypogonadal men nonresponders to the PDE5 inhibitor tadalafil benefit from normalization of testosterone levels with a 1% hydroalcoholic testosterone gel in the treatment of erectile dysfunction (TADTEST study). J Sex Med. 2011;8:284–93. https://doi.org/10.1111/j.1743-6109.2010.01956.x

    CAS  Article  PubMed  Google Scholar 

  35. 35.

    Spitzer M, Basaria S, Travison TG, Davda MN, Paley A, Cohen B, et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med. 2012;157:681–91. https://doi.org/10.7326/0003-4819-157-10-201211200-00004

    Article  PubMed  Google Scholar 

  36. 36.

    Mitkov MD, Aleksandrova IY, Orbetzova MM. Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus. Folia Med (Plovdiv). 2013;55:55–63.

    CAS  Article  Google Scholar 

  37. 37.

    Park MG, Yeo JK, Cho D-Y, Kim JW, Kim JW, Oh MM, et al. The efficacy of combination treatment with injectable testosterone undecanoate and daily tadalafil for erectile dysfunction with testosterone deficiency syndrome. J Sex Med. 2015;12:966–74. https://doi.org/10.1111/jsm.12842

    CAS  Article  PubMed  Google Scholar 

  38. 38.

    Brock G, Heiselman D, Maggi M, Kim SW, Rodríguez Vallejo JM, Behre HM, et al. Effect of testosterone solution 2% on testosterone concentration, sex drive and energy in hypogonadal men: results of a placebo controlled study. J Urol. 2016;195:699–705. https://doi.org/10.1016/j.juro.2015.10.083

    CAS  Article  PubMed  Google Scholar 

  39. 39.

    Paduch DA, Polzer PK, Ni X, Basaria S. Testosterone replacement in androgen-deficient men with ejaculatory dysfunction: a randomized controlled trial. J Clin Endocrinol Metab. 2015;100:2956–62. https://doi.org/10.1210/jc.2014-4434

    CAS  Article  PubMed  Google Scholar 

  40. 40.

    Snyder PJ, Bhasin S, Cunningham GR, Matsumoto AM, Stephens-Shields AJ, Cauley JA, et al. Effects of testosterone treatment in older men. N Engl J Med. 2016;374:611–24. https://doi.org/10.1056/NEJMoa1506119

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Aydin S, Odabaş O, Ercan M, Kara H, Ağargün MY. Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of non-organic male sexual dysfunction. Br J Urol. 1996;77:256–60.

    CAS  Article  Google Scholar 

  42. 42.

    Lawrence IG, Price DE, Howlett TA, Harris KP, Feehally J, Walls J. Correcting impotence in the male dialysis patient: experience with testosterone replacement and vacuum tumescence therapy. Am J Kidney Dis 1998;31:313–9.

    CAS  Article  Google Scholar 

  43. 43.

    Monga M, Kostelec M, Kamarei M. Patient satisfaction with testosterone supplementation for the treatment of erectile dysfunction. Arch Androl. 2002;48:433–42. https://doi.org/10.1080/01485010290099174

    CAS  Article  PubMed  Google Scholar 

  44. 44.

    Park NC, Yan BQ, Chung JM, Lee KM. Oral testosterone undecanoate (Andriol) supplement therapy improves the quality of life for men with testosterone deficiency. Aging Male. 2003;6:86–93.

    CAS  Article  Google Scholar 

  45. 45.

    Greenstein A, Mabjeesh NJ, Sofer M, Kaver I, Matzkin H, Chen J. Does sildenafil combined with testosterone gel improve erectile dysfunction in hypogonadal men in whom testosterone supplement therapy alone failed? J Urol. 2005;173:530–2. https://doi.org/10.1097/01.ju.0000149870.36577.05

    CAS  Article  PubMed  Google Scholar 

  46. 46.

    Hwang TI-S, Chen H-E, Tsai T-F, Lin YC. Combined use of androgen and sildenafil for hypogonadal patients unresponsive to sildenafil alone. Int J Impot Res. 2006;18:400–4. https://doi.org/10.1038/sj.ijir.3901446

    CAS  Article  PubMed  Google Scholar 

  47. 47.

    Tas A, Ersoy A, Ersoy C, Gullulu M, Yurtkuran M. Efficacy of sildenafil in male dialysis patients with erectile dysfunction unresponsive to erythropoietin and/or testosterone treatments. Int J Impot Res. 2006;18:61–8. https://doi.org/10.1038/sj.ijir.3901372

    CAS  Article  PubMed  Google Scholar 

  48. 48.

    Hassan A, El-Hadidy M, El-Deeck BS, Mostafa T. Couple satisfaction to different therapeutic modalities for organic erectile dysfunction. J Sex Med. 2008;5:2381–91. https://doi.org/10.1111/j.1743-6109.2007.00697.x

    CAS  Article  PubMed  Google Scholar 

  49. 49.

    Saad F, Gooren LJ, Haider A, Yassin A. A dose-response study of testosterone on sexual dysfunction and features of the metabolic syndrome using testosterone gel and parenteral testosterone undecanoate. J Androl. 2008;29:102–5. https://doi.org/10.2164/jandrol.107.002774

    CAS  Article  PubMed  Google Scholar 

  50. 50.

    Yassin D-J, Yassin AA, Hammerer PG. Combined testosterone and vardenafil treatment for restoring erectile function in hypogonadal patients who failed to respond to testosterone therapy alone. J Sex Med. 2014;11:543–52. https://doi.org/10.1111/jsm.12378

    CAS  Article  PubMed  Google Scholar 

  51. 51.

    Labairu-Huerta L, Padilla-Fernández B, Arrondo-Arrondo JL, Valverde-Martínez LS, Martín-Rodríguez A, Silva-Abuín JM, et al. PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction. Arch Ital Urol Androl. 2015;87:204–9. https://doi.org/10.4081/aiua.2015.3.204

    CAS  Article  PubMed  Google Scholar 

  52. 52.

    Yassin A, Nettleship JE, Talib RA, Almehmadi Y, Doros G. Effects of testosterone replacement therapy withdrawal and re-treatment in hypogonadal elderly men upon obesity, voiding function and prostate safety parameters. Aging Male. 2016;19:64–9. https://doi.org/10.3109/13685538.2015.1126573

    CAS  Article  PubMed  Google Scholar 

  53. 53.

    Corona G, Rastrelli G, Morgentaler A, Sforza A, Mannucci E, Maggi M.Meta-analysis of results of testosterone therapy on sexual function based on international index of erectile function scores.Eur Urol. 2017;72:1000–1011.

    CAS  Article  Google Scholar 

  54. 54.

    Corona G, Isidori AM, Buvat J, Aversa A, Rastrelli G, Hackett G, et al. Testosterone supplementation and sexual function: a meta-analysis study. J Sex Med. 2014;11:1577–92. https://doi.org/10.1111/jsm.12536

    CAS  Article  PubMed  Google Scholar 

  55. 55.

    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;63:381–94. https://doi.org/10.1111/j.1365-2265.2005.02350.x

    CAS  Article  Google Scholar 

  56. 56.

    Jain P, Rademaker AW, McVary KT. Testosterone supplementation for erectile dysfunction: results of a meta-analysis. J Urol. 2000;164:371–5.

    CAS  Article  Google Scholar 

  57. 57.

    Boloña ER, Uraga MV, Haddad RM, Tracz MJ, Sideras K, Kennedy CC, et al. Testosterone use in men with sexual dysfunction: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc. 2007;82:20–8. https://doi.org/10.4065/82.1.20

    Article  PubMed  Google Scholar 

  58. 58.

    Cunningham GR, Stephens-Shields AJ, Rosen RC, Wang C, Bhasin S, Matsumoto AM, et al. Testosterone treatment and sexual function in older men with low testosterone levels. J Clin Endocrinol Metab. 2016;101:3096–104. https://doi.org/10.1210/jc.2016-1645

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  59. 59.

    Wu F, Zitzmann M, Heiselman D, Donatucci C, Knorr J, Patel AB, et al. Demographic and clinical correlates of patient-reported improvement in sex drive, erectile function, and energy with testosterone solution 2. J Sex Med. 2016;13:1212–9. https://doi.org/10.1016/j.jsxm.2016.05.010

    Article  PubMed  Google Scholar 

  60. 60.

    Huo S, Scialli AR, McGarvey S, Hill E, Tügertimur B, Hogenmiller A, et al. Treatment of men for “Low Testosterone”: a systematic review. PLoS ONE. 2016;11:e0162480 https://doi.org/10.1371/journal.pone.0162480

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  61. 61.

    Tsertsvadze A, Fink HA, Yazdi F, MacDonald R, Bella AJ, Ansari MT, et al. Oral phosphodiesterase-5 inhibitors and hormonal treatments for erectile dysfunction: a systematic review and meta-analysis. Ann Intern Med. 2009;151:650–61. https://doi.org/10.7326/0003-4819-151-9-200911030-00150

    Article  PubMed  Google Scholar 

  62. 62.

    Gooren LJ, Behre HM. Diagnosing and treating testosterone deficiency in different parts of the world: changes between 2006 and 2010. Aging Male. 2012;15:22–7. https://doi.org/10.3109/13685538.2011.650246

    Article  PubMed  Google Scholar 

  63. 63.

    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;49:822–30.

    CAS  Article  Google Scholar 

  64. 64.

    Derogatis LR, Melisaratos N. The DSFI: a multidimensional measure of sexual functioning. J Sex Marital Ther. 1979;5:244–81. https://doi.org/10.1080/00926237908403732

    CAS  Article  PubMed  Google Scholar 

  65. 65.

    O’Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP, Guess HA, et al. A brief male sexual function inventory for urology. Urology. 1995;46:697–706. https://doi.org/10.1016/S0090-4295(99)80304-5

    Article  PubMed  Google Scholar 

  66. 66.

    Morley JE, Charlton E, Patrick P, Kaiser FE, Cadeau P, McCready D, et al. Validation of a screening questionnaire for androgen deficiency in aging males. Metabolism. 2000;49:1239–42. https://doi.org/10.1053/meta.2000.8625

    CAS  Article  PubMed  Google Scholar 

  67. 67.

    Heinemann LAJ, Zimmermann T, Vermeulen A, Thiel C, Hummel W. A new ‘aging males’ symptoms’ rating scale. Aging Male. 1999;2:105–14. https://doi.org/10.3109/13685539909003173

    Article  Google Scholar 

  68. 68.

    Cabral RD, Busin L, Rosito TE, Koff WJ. Performance of Massachusetts Male Aging Study (MMAS) and androgen deficiency in the aging male (ADAM) questionnaires in the prediction of free testosterone in patients aged 40 years or older treated in outpatient regimen. Aging Male. 2014;17:147–54. https://doi.org/10.3109/13685538.2014.908460

    CAS  Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Konstantinos Dimitropoulos.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dimitropoulos, K., Verze, P., Van den Broeck, T. et al. What are the benefits and harms of testosterone therapy for male sexual dysfunction?—a systematic review. Int J Impot Res 31, 380–391 (2019). https://doi.org/10.1038/s41443-019-0131-1

Download citation

Further reading

Search

Quick links