The role of testosterone in male sexual function

被引:36
作者
Corona, Giovanni [1 ]
Maggi, Mario [2 ]
机构
[1] Azienda Usl, Maggiore Bellaria Hosp, Endocrinol Unit, Med Dept, Bologna, Italy
[2] Univ Florence, Dept Expt & Clin Biomed Sci, Endocrinol Unit, Florence, Mario Serio, Italy
关键词
Testosterone; Hypogonadism; Testosterone replacement therapy; Erectile dysfunction; PHOSPHODIESTERASE; 5; INHIBITORS; ERECTILE DYSFUNCTION; OLDER MEN; HYPOGONADAL MEN; INTERNATIONAL INDEX; RISK-FACTORS; DELAYED EJACULATION; SERUM TESTOSTERONE; METABOLIC PROFILE; DOUBLE-BLIND;
D O I
10.1007/s11154-022-09748-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Sexual function, and testosterone (T) levels, progressively decline in aging men. Associated morbidities and metabolic disorders can accelerate the phenomenon. The specific contribution of low T to sexual function impairment in aging men has still not been completely clarified. Similarly, the role of T replacement therapy (TRT), as well as the combination of TRT with phosphodiesterase type 5 inhibitors (PDE5i) for patients with erectile dysfunction (ED), is still conflicting. Here we aim to summarize and critically discuss all available data supporting the contribution of low T to sexual impairment observed with aging as well as the possible role of TRT. Available data on men with sexual dysfunction show that reduced sexual desire is the most important correlate of male hypogonadism. Conversely, aging and associated morbidities substantially attenuate the relationship between ED and T. TRT is effective in improving sexual function in middle-aged and older subjects but its role is small and extremely variable. Lifestyle interventions can result in similar outcomes to those of TRT. In conclusion, it is our opinion that PDE5i along with lifestyle measures should be considered the first approach for treating ED even in subjects with milder T deficiency. When these interventions fail or are difficult to apply, TRT should be considered.
引用
收藏
页码:1159 / 1172
页数:14
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