A recent study on testosterone treatment for older men shows modest sexual benefits but lacks proper evaluation of relative risks for people who receive the treatment.
Thomas Gill, professor of epidemiology and study co-author, said the research — published in the New England Journal of Medical Science on Feb. 18 — was conducted through a national, multi-centered trial. The study examined the benefits of testosterone treatment for men, aged 65 and older, in relation to their sexuality, physicality and vitality. With over 118 collaborators, the data analysis from the study established modest benefits of testosterone treatment for sexual function, and some benefit for mood and depressive symptoms in participants. However, other doctors described the study as questionable because of the neglect by study authors to assess the treatment’s relative risks.
“Some men may only be having problems with erectile function, but if men were losing sexual interest, testosterone might be more beneficial [than Viagra], because it treats that specifically,” Gill said.
Gill noted that the three areas evaluated — sexuality, physicality and vitality — are part of a larger trial which aims to also study cardiovascular, bone and cognitive health in response to testosterone. Results for the other trials will be available in the coming years, he added.
According to the study, testosterone concentrations in men over the age of 65 had significant effects on all measures of sexual function, including activity, desire and erectile function.
“Although the benefits were modest and moderate, the testosterone group was more likely than those in the placebo group to report their improved sexual desire,” Gill said.
He noted that testosterone also had a small effect on mood and depressive symptoms, but it had neither a significant impact on vitality nor a large impact on the participants’ physical function.
Thomas Perls, professor at Boston University School of Medicine and founding director of the New England Centenarian Study, emphasized the futility of the study. He said the small benefits of testosterone in libido and physical functions were irrelevant because there was no examination of relative risks. He explained that testosterone supplements have been marketed to men with adult-onset hypogonadism — low testosterone levels — for some time. Until 1990, only 0.5 percent of men had actually developed this syndrome, despite the marketing campaigns’ desire to reach a larger population of men.
“First of all, we didn’t need a very expensive drug study to tell us that testosterone can [improve libido and stamina]. This is what testosterone does; it’s in steroids, and we know that,” Perls said. “Also, the trial was way too small and short of a duration to measure potential risks.”
Perls highlighted that the final problem was that 61 percent of the subjects were obese. Obesity is already proven to decrease sexual libido and stamina, he said. Half of the study’s authors were associated with the drug companies that sell testosterone, he added.
According to John Hopkins Medicine, erectile dysfunction affects almost all men at one point in their lives and affects as many as 30 million American men, including 30 to 50 percent of men between the ages of 40 and 70.