The effect of testosterone therapy on erectile dysfunction in type 2 diabetic patients

Introduction Erectile dysfunction (ED) is commonly observed in Type 2 diabetic men, affecting approximately 75% of this demographic. Evidence suggests that phosphodiesterase-5 (PDE-5) inhibitors have limited therapeutic effects on progressive ED in men with Type 2 diabetes, indicating the need for alternative treatment lines. This study aims to investigate the effects of testosterone therapy on ED in Type 2 diabetic patients with normal testosterone levels. Materials and methods This single-blind randomized clinical trial was conducted on Type 2 diabetic men with normal testosterone levels and erectile dysfunction. The control group received standard treatment with tadalafil 20 mg two hours before intercourse. In contrast, the intervention group, in addition to tadalafil, received 250 mg of intramuscular testosterone at 3 points (the start, and at 1 and 2 months afterwards. Informed consent was obtained, and participants were selected based on inclusion and exclusion criteria. Findings A total of 60 Type 2 diabetic patients with ED were included, with an average age of 50.4 +/- 9.7 years. Significant differences were observed between the intervention and control groups in terms of average total testosterone and International Index of Erectile Function (IIEF) scores (P value < 0.01), with the intervention group showing higher averages. These differences were also significant over time (P value < 0.01), indicating improved outcomes concerning the baseline. Conclusion Testosterone therapy in diabetic men led to improvements in sexual desire and ED without adverse effects on liver function.