Testosterone, Viagra not a winning combination for erectile dysfunction

Using a testosterone gel in addition to Viagra doesn't make the little blue pill work any better, according to a new study.

The report's lead researcher said testosterone is typically prescribed to men who have both low testosterone levels and symptoms such as little interest in sex or low bone and muscle mass.

But, "there's a tremendous amount of clinical judgment" that goes into that, said Dr. Matthew Spitzer, from the Boston University School of Medicine. "People are certainly being prescribed and using these medications at increasing amounts."

According to Spitzer, studies have suggested that about one-quarter to one-third of men with erectile dysfunction, or ED, also have low testosterone. There's a range in part because doctors and researchers don't all agree on where the cutoff should be for low levels of the male sex hormone.

Spitzer and his colleagues found that a starting course of sildenafil citrate, marketed as Viagra, helped improve sexual functioning for men with both conditions. But adding testosterone on top of that didn't provide any added sexual benefits.

The study included 140 men, aged 40 to 70. All were prescribed Viagra at 50 or 100 milligrams, which they took as needed before sex. After three to seven weeks, half of the men were randomly assigned to also use a daily testosterone gel, Testim, and the other half used a drug-free placebo gel.

During the Viagra-only portion of the study, men's erectile function scores improved. On the sexual functioning scale, a score of 11-16 is considered "moderate" erectile dysfunction and 17-21 is "mild to moderate" dysfunction. The highest possible score, signaling no erectile problems, is a 30. On average, men's scores increased from 12.1 to 19.8 with Viagra.

The men's testosterone levels also rose on Viagra, according to the findings published Monday in the Annals of Internal Medicine.

For men who were then given the testosterone gel, testosterone levels increased significantly again. But neither those men nor the ones who used the placebo gel had any further change in their erectile function over the next three months.

There was also no difference between the two groups on measures of sexual desire, orgasm and frequency of intercourse.

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Testosterone, Viagra not a winning combination for erectile dysfunction