Endocrine Abstracts

Objective: The role of testosterone in the anatomy and physiology of erection is becoming clear. Erectile dysfunctions (ED) are very common observed in men with diabetes mellitus type 2 (DM2). The aim of the study was to determine the efficacy of testosterone adminisartions in elderly men with ED and DM2.

Material and methods: We investigated 41 men mean aged 65.4 years with late onset hypogonadism according Polish Endocrine Society recommendations and DM2 according ADA recommendations, who had not been treated with PDE5 inhibitors. All men received testosterone enanthate in dose of 200 mg. i.m. every second week. Durations of treatment was mean 12 weeks. Efficacy of treatment was measured by the IIEF domain before and after 4 and 12 weeks of treatment. All of men were treated with oral antidiabetic drugs or insulin. Hypogonadism was expected on the basis of low testosterone concentration (≤3.5 μg/l) and the index T/LH≤1.

Results: After 4 weeks of treatment 21/41 patients showed improvement in erections. At the and of 4 month 32/41 patients showed improvement in the score on IIEF (from 7.9±3.2 to 12.3±3.4; P<0.05). There were inverted correlations between testosterone levels and efficacy of testosterone treatment and also between duration of DM2 and IIEF score.

Conclusions: In elderly men with hypogonadism related to aging (late-onset hypogonadism) and diabetes mellitus 2 after 1 month of testosterone replacement therapy there was a small number of patients in whom treatment results in erectile improvement, but many more patients benefit after 3 months of therapy. Testosterone therapy is time-dependent and combination with PDE5 inhibitors should start only after at least 3-months of monotherapy with testosterone.