Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review

Purpose: To assess the effects of testosterone replacement therapy (TRT) compared to placebo or other medical treatments in men with sexual dysfunction. Materials and Methods: We performed a comprehensive search with no restrictions on publication language or status up to 29 August 2023. We only...

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Main Authors: Hunju Lee, Eu Chang Hwang, Cheol Kyu Oh, Solam Lee, Ho Song Yu, Jung Soo Lim, Hong Wook Kim, Thomas Walsh, Myung Ha Kim, Jae Hung Jung, Philipp Dahm
Format: Article
Language:English
Published: Korean Society for Sexual Medicine and Andrology 2025-07-01
Series:The World Journal of Men's Health
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author Hunju Lee
Eu Chang Hwang
Cheol Kyu Oh
Solam Lee
Ho Song Yu
Jung Soo Lim
Hong Wook Kim
Thomas Walsh
Myung Ha Kim
Jae Hung Jung
Philipp Dahm
author_facet Hunju Lee
Eu Chang Hwang
Cheol Kyu Oh
Solam Lee
Ho Song Yu
Jung Soo Lim
Hong Wook Kim
Thomas Walsh
Myung Ha Kim
Jae Hung Jung
Philipp Dahm
author_sort Hunju Lee
collection DOAJ
description Purpose: To assess the effects of testosterone replacement therapy (TRT) compared to placebo or other medical treatments in men with sexual dysfunction. Materials and Methods: We performed a comprehensive search with no restrictions on publication language or status up to 29 August 2023. We only included randomized controlled trials (RCTs). Results: We identified 43 studies with 11,419 randomized participants. We found that TRT likely results in little to no difference in erectile function assessed with the IIEF-EF (mean difference [MD]: 2.37, 95% confidence interval [CI]: 1.67 to 3.08; I2=0%; 6 RCTs, 2016 participants; moderate-certainty evidence) compared to placebo. TRT likely results in little to no change in sexual quality of life assessed with the Aging Males’ Symptoms scale (MD: -2.31, 95% CI: -3.63 to -1.00; I2=0%; 5 RCTs, 1,030 participants; moderate-certainty evidence) compared to placebo. TRT also likely results in little to no difference in cardiovascular mortality (risk ratio: 0.83, 95% CI: 0.21 to 3.26; I2=0%; 10 RCTs, 3,525 participants; moderate-certainty evidence) compared to placebo. TRT also likely results in little to no difference in treatment withdrawal due to adverse events, prostate-related events, or lower urinary tract symptoms. Conclusions: TRT for men with sexual dysfunction showed no difference in erectile function, sexual quality of life, or cardiovascular mortality compared to placebo. Furthermore, it also appears to no difference in treatment withdrawals due to adverse events, prostate-related events, or lower urinary tract symptoms.
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spelling doaj-art-e974a14560dd47ea8f8d0cbef53bbccb2025-08-20T03:23:27ZengKorean Society for Sexual Medicine and AndrologyThe World Journal of Men's Health2287-42082287-46902025-07-0143353955110.5534/wjmh.240146Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic ReviewHunju Lee0https://orcid.org/0000-0003-0089-0069Eu Chang Hwang1https://orcid.org/0000-0002-2031-124XCheol Kyu Oh2https://orcid.org/0000-0002-0497-6057Solam Lee3https://orcid.org/0000-0001-6458-9449Ho Song Yu4https://orcid.org/0000-0001-6839-8594Jung Soo Lim5https://orcid.org/0000-0003-4856-3462Hong Wook Kim6https://orcid.org/0000-0002-3847-1401Thomas Walsh7https://orcid.org/0000-0001-6584-1271Myung Ha Kim8https://orcid.org/0000-0002-7899-3407Jae Hung Jung9https://orcid.org/0000-0002-4990-7098Philipp Dahm10https://orcid.org/0000-0003-2819-2553Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, KoreaDepartment of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, KoreaDepartment of Urology, Inje University Haeundae Paik Hospital, Busan, KoreaDepartment of Dermatology, Yonsei University Wonju College of Medicine, Wonju, KoreaDepartment of Urology, Chonnam National University Medical School, Gwangju, KoreaDivision of Endocrinology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, KoreaDepartment of Urology, Konyang University College of Medicine, Daejeon, KoreaImmunocompromised Host Section, Pediatric Oncology Branch, National Cancer Institute, Bethesda, MD, USAYonsei Wonju Medical Library, Yonsei University Wonju College of Medicine, Wonju, KoreaCenter of Evidence-Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, KoreaDepartment of Urology, University of Minnesota, Minneapolis, MN, USAPurpose: To assess the effects of testosterone replacement therapy (TRT) compared to placebo or other medical treatments in men with sexual dysfunction. Materials and Methods: We performed a comprehensive search with no restrictions on publication language or status up to 29 August 2023. We only included randomized controlled trials (RCTs). Results: We identified 43 studies with 11,419 randomized participants. We found that TRT likely results in little to no difference in erectile function assessed with the IIEF-EF (mean difference [MD]: 2.37, 95% confidence interval [CI]: 1.67 to 3.08; I2=0%; 6 RCTs, 2016 participants; moderate-certainty evidence) compared to placebo. TRT likely results in little to no change in sexual quality of life assessed with the Aging Males’ Symptoms scale (MD: -2.31, 95% CI: -3.63 to -1.00; I2=0%; 5 RCTs, 1,030 participants; moderate-certainty evidence) compared to placebo. TRT also likely results in little to no difference in cardiovascular mortality (risk ratio: 0.83, 95% CI: 0.21 to 3.26; I2=0%; 10 RCTs, 3,525 participants; moderate-certainty evidence) compared to placebo. TRT also likely results in little to no difference in treatment withdrawal due to adverse events, prostate-related events, or lower urinary tract symptoms. Conclusions: TRT for men with sexual dysfunction showed no difference in erectile function, sexual quality of life, or cardiovascular mortality compared to placebo. Furthermore, it also appears to no difference in treatment withdrawals due to adverse events, prostate-related events, or lower urinary tract symptoms.hormone replacement therapysexual dysfunction; physiologicalsystematic reviewtestosterone
spellingShingle Hunju Lee
Eu Chang Hwang
Cheol Kyu Oh
Solam Lee
Ho Song Yu
Jung Soo Lim
Hong Wook Kim
Thomas Walsh
Myung Ha Kim
Jae Hung Jung
Philipp Dahm
Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
The World Journal of Men's Health
hormone replacement therapy
sexual dysfunction; physiological
systematic review
testosterone
title Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
title_full Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
title_fullStr Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
title_full_unstemmed Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
title_short Testosterone Replacement in Men with Sexual Dysfunction: An Abridged Version of the Cochrane Systematic Review
title_sort testosterone replacement in men with sexual dysfunction an abridged version of the cochrane systematic review
topic hormone replacement therapy
sexual dysfunction; physiological
systematic review
testosterone
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