Testosterone use in men with sexual dysfunction: A systematic review and meta-analysis of randomized placebo-controlled trials

Enrique R. Boloña, Maria V. Uraga, Rudy M. Haddad, Michal J. Tracz, Kostandinos Sideras, Cassie Kennedy, Sean M. Caples, Patricia J. Erwin, Victor Manuel Montori

Research output: Contribution to journalArticle

168 Citations (Scopus)

Abstract

OBJECTIVE: To conduct a systematic review and meta-analysis of randomized placebo-controlled trials to measure the effect of testosterone use on sexual function in men with sexual dysfunction and varying testosterone levels. METHODS: Librarian-designed search strategies were used to search the MEDLINE (1966 to October 2004), EMBASE (1988 to October 2004), and Cochrane CENTRAL (inception to October 2004) databases. The MEDLINE search was rerun in March 2005. We also reviewed reference lists from included studies and content expert files. We selected randomized placebo-controlled trials of testosterone vs placebo that enrolled men with sexual dysfunction and measured satisfaction with erectile function and libido and overall sexual satisfaction. RESULTS: We included 17 trials (N=862 participants) in this review. Trials that enrolled participants with low testosterone levels showed (1) a moderate nonsignificant and inconsistent effect of testosterone use on satisfaction with erectile function (random-effects pooled effect size, 0.80; 95% confidence interval [CI], -0.10 to 1.60), (2) a large effect on libido (pooled effect size, 1.31; 95% CI, 0.40 to 2.25), and (3) no significant effect on overall sexual satisfaction. Trials that enrolled patients with low-normal and normal testosterone levels at baseline showed testosterone that caused (1) a small effect on satisfaction with erectile function (pooled effect size, 0.34; 95% CI, 0.03 to 0.65), (2) moderate nonsignificant effect on libido (pooled effect size, 0.41; 95% CI, -0.01 to 0.83), and (3) no significant effect on overall sexual satisfaction. CONCLUSION: Testosterone use in men is associated with small improvements in satisfaction with erectile function and moderate improvements in libido. Unexplained inconsistent results across trials, wide CIs, and possible reporting bias weaken these inferences.

Original languageEnglish (US)
Pages (from-to)20-28
Number of pages9
JournalMayo Clinic Proceedings
Volume82
Issue number1
DOIs
StatePublished - 2007

Fingerprint

Testosterone
Meta-Analysis
Randomized Controlled Trials
Placebos
Libido
Orgasm
Confidence Intervals
MEDLINE
Librarians
Databases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Testosterone use in men with sexual dysfunction : A systematic review and meta-analysis of randomized placebo-controlled trials. / Boloña, Enrique R.; Uraga, Maria V.; Haddad, Rudy M.; Tracz, Michal J.; Sideras, Kostandinos; Kennedy, Cassie; Caples, Sean M.; Erwin, Patricia J.; Montori, Victor Manuel.

In: Mayo Clinic Proceedings, Vol. 82, No. 1, 2007, p. 20-28.

Research output: Contribution to journalArticle

Boloña, Enrique R. ; Uraga, Maria V. ; Haddad, Rudy M. ; Tracz, Michal J. ; Sideras, Kostandinos ; Kennedy, Cassie ; Caples, Sean M. ; Erwin, Patricia J. ; Montori, Victor Manuel. / Testosterone use in men with sexual dysfunction : A systematic review and meta-analysis of randomized placebo-controlled trials. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 1. pp. 20-28.
@article{816f487ed57345b39a63e5acdeeffe70,
title = "Testosterone use in men with sexual dysfunction: A systematic review and meta-analysis of randomized placebo-controlled trials",
abstract = "OBJECTIVE: To conduct a systematic review and meta-analysis of randomized placebo-controlled trials to measure the effect of testosterone use on sexual function in men with sexual dysfunction and varying testosterone levels. METHODS: Librarian-designed search strategies were used to search the MEDLINE (1966 to October 2004), EMBASE (1988 to October 2004), and Cochrane CENTRAL (inception to October 2004) databases. The MEDLINE search was rerun in March 2005. We also reviewed reference lists from included studies and content expert files. We selected randomized placebo-controlled trials of testosterone vs placebo that enrolled men with sexual dysfunction and measured satisfaction with erectile function and libido and overall sexual satisfaction. RESULTS: We included 17 trials (N=862 participants) in this review. Trials that enrolled participants with low testosterone levels showed (1) a moderate nonsignificant and inconsistent effect of testosterone use on satisfaction with erectile function (random-effects pooled effect size, 0.80; 95{\%} confidence interval [CI], -0.10 to 1.60), (2) a large effect on libido (pooled effect size, 1.31; 95{\%} CI, 0.40 to 2.25), and (3) no significant effect on overall sexual satisfaction. Trials that enrolled patients with low-normal and normal testosterone levels at baseline showed testosterone that caused (1) a small effect on satisfaction with erectile function (pooled effect size, 0.34; 95{\%} CI, 0.03 to 0.65), (2) moderate nonsignificant effect on libido (pooled effect size, 0.41; 95{\%} CI, -0.01 to 0.83), and (3) no significant effect on overall sexual satisfaction. CONCLUSION: Testosterone use in men is associated with small improvements in satisfaction with erectile function and moderate improvements in libido. Unexplained inconsistent results across trials, wide CIs, and possible reporting bias weaken these inferences.",
author = "Bolo{\~n}a, {Enrique R.} and Uraga, {Maria V.} and Haddad, {Rudy M.} and Tracz, {Michal J.} and Kostandinos Sideras and Cassie Kennedy and Caples, {Sean M.} and Erwin, {Patricia J.} and Montori, {Victor Manuel}",
year = "2007",
doi = "10.4065/82.1.20",
language = "English (US)",
volume = "82",
pages = "20--28",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "1",

}

TY - JOUR

T1 - Testosterone use in men with sexual dysfunction

T2 - A systematic review and meta-analysis of randomized placebo-controlled trials

AU - Boloña, Enrique R.

AU - Uraga, Maria V.

AU - Haddad, Rudy M.

AU - Tracz, Michal J.

AU - Sideras, Kostandinos

AU - Kennedy, Cassie

AU - Caples, Sean M.

AU - Erwin, Patricia J.

AU - Montori, Victor Manuel

PY - 2007

Y1 - 2007

N2 - OBJECTIVE: To conduct a systematic review and meta-analysis of randomized placebo-controlled trials to measure the effect of testosterone use on sexual function in men with sexual dysfunction and varying testosterone levels. METHODS: Librarian-designed search strategies were used to search the MEDLINE (1966 to October 2004), EMBASE (1988 to October 2004), and Cochrane CENTRAL (inception to October 2004) databases. The MEDLINE search was rerun in March 2005. We also reviewed reference lists from included studies and content expert files. We selected randomized placebo-controlled trials of testosterone vs placebo that enrolled men with sexual dysfunction and measured satisfaction with erectile function and libido and overall sexual satisfaction. RESULTS: We included 17 trials (N=862 participants) in this review. Trials that enrolled participants with low testosterone levels showed (1) a moderate nonsignificant and inconsistent effect of testosterone use on satisfaction with erectile function (random-effects pooled effect size, 0.80; 95% confidence interval [CI], -0.10 to 1.60), (2) a large effect on libido (pooled effect size, 1.31; 95% CI, 0.40 to 2.25), and (3) no significant effect on overall sexual satisfaction. Trials that enrolled patients with low-normal and normal testosterone levels at baseline showed testosterone that caused (1) a small effect on satisfaction with erectile function (pooled effect size, 0.34; 95% CI, 0.03 to 0.65), (2) moderate nonsignificant effect on libido (pooled effect size, 0.41; 95% CI, -0.01 to 0.83), and (3) no significant effect on overall sexual satisfaction. CONCLUSION: Testosterone use in men is associated with small improvements in satisfaction with erectile function and moderate improvements in libido. Unexplained inconsistent results across trials, wide CIs, and possible reporting bias weaken these inferences.

AB - OBJECTIVE: To conduct a systematic review and meta-analysis of randomized placebo-controlled trials to measure the effect of testosterone use on sexual function in men with sexual dysfunction and varying testosterone levels. METHODS: Librarian-designed search strategies were used to search the MEDLINE (1966 to October 2004), EMBASE (1988 to October 2004), and Cochrane CENTRAL (inception to October 2004) databases. The MEDLINE search was rerun in March 2005. We also reviewed reference lists from included studies and content expert files. We selected randomized placebo-controlled trials of testosterone vs placebo that enrolled men with sexual dysfunction and measured satisfaction with erectile function and libido and overall sexual satisfaction. RESULTS: We included 17 trials (N=862 participants) in this review. Trials that enrolled participants with low testosterone levels showed (1) a moderate nonsignificant and inconsistent effect of testosterone use on satisfaction with erectile function (random-effects pooled effect size, 0.80; 95% confidence interval [CI], -0.10 to 1.60), (2) a large effect on libido (pooled effect size, 1.31; 95% CI, 0.40 to 2.25), and (3) no significant effect on overall sexual satisfaction. Trials that enrolled patients with low-normal and normal testosterone levels at baseline showed testosterone that caused (1) a small effect on satisfaction with erectile function (pooled effect size, 0.34; 95% CI, 0.03 to 0.65), (2) moderate nonsignificant effect on libido (pooled effect size, 0.41; 95% CI, -0.01 to 0.83), and (3) no significant effect on overall sexual satisfaction. CONCLUSION: Testosterone use in men is associated with small improvements in satisfaction with erectile function and moderate improvements in libido. Unexplained inconsistent results across trials, wide CIs, and possible reporting bias weaken these inferences.

UR - http://www.scopus.com/inward/record.url?scp=33845917336&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845917336&partnerID=8YFLogxK

U2 - 10.4065/82.1.20

DO - 10.4065/82.1.20

M3 - Article

C2 - 17285782

AN - SCOPUS:33845917336

VL - 82

SP - 20

EP - 28

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 1

ER -