Medline ® Abstract for Reference 136
of 'Treatment of male sexual dysfunction'
Testosterone Replacement in Androgen-Deficient Men With Ejaculatory Dysfunction: A Randomized Controlled Trial.
Paduch DA, Polzer PK, Ni X, Basaria S
J Clin Endocrinol Metab. 2015 Aug;100(8):2956-62. Epub 2015 Jul 9.
CONTEXT: Low T levels have been associated with ejaculatory dysfunction (EjD) in cross-sectional studies; however, the efficacy of T replacement in improving EjD has not been studied in a randomized controlled trial.
OBJECTIVE: To evaluate the efficacy of T replacement in androgen-deficient men with EjD.
DESIGN: A multicenter, double-blind, randomized, placebo-controlled, 16-week trial with T solution 2% versus placebo.
SETTING: Medical centers in the United States, Canada, and Mexico.
PATIENTS OR OTHER PARTICIPANTS: Seventy-six men with one or more EjD symptoms, including delayed ejaculation, anejaculation,reduced ejaculate volume, and/or reduced force of ejaculation, and two total T levels<300 ng/dL (<10.41 nmol/L) measured with liquid chromatography tandem mass spectrometry.
INTERVENTIONS: Sixty milligrams of T solution 2% or placebo applied to the axillae for 16 weeks.
MAIN OUTCOME MEASURES: The primary outcome was a change in the score of the three-item Male Sexual Health Questionnaire-Ejaculatory Dysfunction-Short Form (MSHQ-EjD-SF); secondary outcomes included measured ejaculate volume, scores of the bother/satisfaction item of the MSHQ-EjD-SF, the orgasmic function domain of the International Index of Erectile Function Questionnaire, and the sexual activity log.
RESULTS: Seventy-six participants were randomized; 66 completed the study. Baseline demographic and clinical characteristics were comparable between the treatment arms. T replacement improved the MSHQ-EjD-SF score (mean score change, +3.1); however, this effect was not statistically different from placebo (mean score change, +2.5; P = .596). No differences were seen in any of the secondary outcomes or frequency of adverse events.
CONCLUSION: T replacement was not associated with significant improvement in EjD in androgen-deficient men.
Department of Urology (D.A.P.), Weill Cornell Medical College, New York, New York 10065; Lilly Research Laboratories (P.K.P., X.N.), Eli Lilly and Company, Indianapolis, Indiana 46285; and Section on Men's Health, Aging, and Metabolism (S.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.