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Observational data have suggested that low levels of testosterone are associated with ejaculatory dysfunction. In this randomized trial, industry-sponsored researchers examined whether testosterone replacement improves ejaculatory dysfunction in men with low testosterone levels. The study included 76 sexually active men (mean age, 50) with two measured testosterone levels <300 ng/dL and either delayed ejaculation, anejaculation, low force of ejaculation, or low ejaculate volume.
Men were randomized to apply testosterone solution or placebo daily for 16 weeks. Mean serum testosterone levels rose to 488 ng/dL (from a baseline level of 214 ng/dL) in the treatment group and did not change in the placebo group. During the trial, no significant differences emerged between groups in frequency or force of ejaculation, ejaculate volume, or degree of bother or satisfaction with ejaculation. In addition, researchers found no differences between groups in orgasmic pleasure or frequency of orgasm.
Paduch DA et al. Testosterone replacement in androgen-deficient men with ejaculatory dysfunction: A randomized controlled trial. J Clin Endocrinol Metab 2015 Aug; 100:2956. (http://dx.doi.org/10.1210/jc.2014-4434)
Comment
This study joins another recent trial in which testosterone supplementation did not improve sexual function (NEJM JW Gen Med Sep 15 2015 and JAMA 2015; 314:570). In my experience, a desire to improve ejaculation or orgasm is not the most common reason that men request testosterone supplementation. Nevertheless, this study demonstrates that testosterone is ineffective for such symptoms in men with mildly low testosterone blood levels.