The Journal of clinical endocrinology and metabolism · 2016
Testosterone Treatment and Sexual Function in Older Men With Low Testosterone Levels.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАПоддержка правительства СШАПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Cunningham Glenn R, Stephens-Shields Alisa J, Rosen Raymond C, Wang Christina, Bhasin Shalender, Matsumoto Alvin M, Parsons J Kellogg, Gill Thomas M, Molitch Mark E, Farrar John T, Cella David, Barrett-Connor Elizabeth, Cauley Jane A, Cifelli Denise, Crandall Jill P, Ensrud Kristine E, Gallagher Laura, Zeldow Bret, Lewis Cora E, Pahor Marco, Swerdloff Ronald S, Hou Xiaoling, Anton Stephen, Basaria Shehzad, Diem Susan J, Tabatabaie Vafa, Ellenberg Susan S, Snyder Peter J
Аннотация
CONTEXT: The Testosterone Trials are a coordinated set of seven trials to determine the efficacy of T in symptomatic men ≥65 years old with unequivocally low T levels. Initial results of the Sexual Function Trial showed that T improved sexual activity, sexual desire, and erectile function.
OBJECTIVE: To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes.
DESIGN: A placebo-controlled trial.
SETTING: Twelve academic medical centers in the United States.
PARTICIPANTS: A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month.
METHODS: Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function.
RESULTS: Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T.
CONCLUSIONS: In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.
OBJECTIVE: To assess the responsiveness of specific sexual activities to T treatment; to relate hormone changes to changes in sexual function; and to determine predictive baseline characteristics and T threshold for sexual outcomes.
DESIGN: A placebo-controlled trial.
SETTING: Twelve academic medical centers in the United States.
PARTICIPANTS: A total of 470 men ≥65 years of age with low libido, average T <275 ng/dL, and a partner willing to have sexual intercourse at least twice a month.
METHODS: Men were assigned to take T gel or placebo for 1 year. Sexual function was assessed by three questionnaires every 3 months: the Psychosexual Daily Questionnaire, the Derogatis Interview for Sexual Function, and the International Index of Erectile Function.
RESULTS: Compared with placebo, T administration significantly improved 10 of 12 measures of sexual activity. Incremental increases in total and free T and estradiol levels were associated with improvements in sexual activity and desire, but not erectile function. No threshold T level was observed for any outcome, and none of the 27 baseline characteristics predicted responsiveness to T.
CONCLUSIONS: In older men with low libido and low T levels, improvements in sexual desire and activity in response to T treatment were related to the magnitude of increases in T and estradiol levels, but there was no clear evidence of a threshold effect.