For men approaching middle age, testosterone therapy is heralded as a miracle drug. Citing benefits from improved muscle tone to boundless energy, commercials featuring ripped septuagenarians have turned elective testosterone into a multi-billion dollar industry. However, a new study published in the Journal of the American Medical Association yields a mixed bag of results: While some of the risks of testosterone therapy have been overstated, it appears to do little to improve sexual function.
“We find that men with low and low normal testosterone are unlikely to derive benefits in terms of sexual function or quality of life, two reasons why men may seek testosterone therapy. And although we find that testosterone did not affect the rate of hardening of the arteries, we need long-term data from large trials to determine testosterone’s effects on other major cardiovascular events,” said lead author Shalender Bhasin, MD, director of Brigham and Women’s Hospital’s Research Program in Men’s Health: Aging and Metabolism and director of the Boston Claude D. Pepper Older Americans Independence Center at BWH.
For anyone, the loss of sexual function is a crippling blow to both the ego and psyche in general – without it, you literally have no biological reason to exist. Even for people who already have children (or never wanted them), that’s a hard pill to swallow. Throw in the fact that sex is a fun, essential component of most romantic relationships, and it’s easy to see why men would spend so much money in order to get it back. There’s yet another psychological component: It’s more comforting to blame poor sexual function on a hormone deficiency than it is to admit to other factors that may be better treated by drugs like Viagra or Ciallis.
However, the reality is that for most men, sexual function in middle and advanced age has little to do with testosterone levels. Things like stress, body mass, cardiovascular health and mental state are all more likely to affect one’s ability to attain and maintain an erection. For men looking to improve sexual function, a drug that improves blood flow (along with a healthy diet and exercise regimen) is probably a better solution.
The research wasn’t a total bummer, however. While earlier research suggested that testosterone therapy had a negative effect on cardiovascular health and hardening of the arteries. As Bhasin mentioned, this does not appear to be the case. In the study of more than 300 men over the age of 60 with total testosterone levels between 100-400 ng/dL (low to low normal range), two different measures of atherosclerosis found no evidence that testosterone therapy increased risk. The men in the experimental group applied a testosterone gel every day for three years.
“Our study has important implications for clinical practice, and for older men who are seeking testosterone therapy,” said Bhasin. “Many men, as they get older, experience a decline in testosterone and in sexual function and vitality. But our study finds that taking testosterone, when levels are in the low to low normal range, may not improve sexual function or quality of life.”