Testosterone's Evolving Role in Treating ED

Erectile dysfunction (ED) is a complex condition that may be caused by vascular (affecting the blood vessels), neurological, and psychological factors, or a combination of all three.

Approximately 10 percent to 15 percent of men with ED suffer from low testosterone levels, or hypogonadism. Up to a quarter of all men are estimated to have low testosterone levels, which is even more common among men over age 60.)

When low testosterone is the cause of ED, studies show that about 40 percent to 60 percent of men respond to treatment with testosterone supplementation. When other factors are involved, however, testosterone treatment alone is not nearly as effective to cure ED, even though it may increase sexual desire.

Over the past several years, drugs known as PDE5 inhibitors (Viagra, Levitra, Cialis) have become the first line treatment for ED, regardless of its cause or severity. But these drugs still don't help a significant proportion - estimates range from 25 percent to 50 percent - of the men who take them. Recently, we have learned that many of these PDE5 failures occur in men with low testosterone. This should not be surprising since hormones, like testosterone, are essential to the mechanisms involved in erection.

Armed with this new information, some doctors are using a combination therapy that includes a PDE5 inhibitor and testosterone supplementation in men with ED who don't respond to treatment with PDE5 inhibitors alone. Up to 70 percent of men with documented low testosterone levels have been shown to respond when testosterone is added. The treatment also improved the men's quality of orgasms and overall quality of life.

If you continue to suffer from ED after treatment with PDE5 inhibitors, consider asking your doctor to measure your testosterone level. This may provide important new information that may lead to effective treatment of your ED.