Testosterone replacement added to sildenafil therapy is no better than sildenafil plus placebo at improving erectile function in men with erectile dysfunction (ED) and low testosterone.
Approximately one in three men over the age of 50 suffers from ED and many of them also have low testosterone. Researchers randomly assigned 140 men with ED and low testosterone between the ages of 40 and 70 to either 14 weeks of sildenafil plus 10-g of daily transdermal testosterone gel or sildenafil plus placebo to determine whether the addition of testosterone to dose-optimized sildenafil therapy would improve erectile function.
All participants had similar erectile function at baseline. Sildenafil alone was associated with a substantial increase in erectile function. Adding testosterone or placebo had no effect on erectile function and adverse events were similar for both groups.
The authors note that while testosterone added to sildenafil may not improve erectile function, it may have other benefits such as improved body composition, muscle strength, physical cognition, and metabolism, although these outcomes were not investigated.