Effects of Testosterone Replacement on Response to Sildenafil Citrate
Authors: Antonio Aversa, Emmanuele A. Jannini, Mario Maggi, Andrea Lenzi
Journal: Annals of Internal Medicine (2013)

Letters2 April 2013Effects of Testosterone Replacement on Response to Sildenafil CitrateAntonio Aversa, MD, PhD, Emmanuele A. Jannini, MD, Mario Maggi, MD, and Andrea Lenzi, MDAntonio Aversa, MD, PhDFrom Sapienza University of Rome, Rome, Italy., Emmanuele A. Jannini, MDFrom Sapienza University of Rome, Rome, Italy., Mario Maggi, MDFrom Sapienza University of Rome, Rome, Italy., and Andrea Lenzi, MDFrom Sapienza University of Rome, Rome, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-7-201304020-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Spitzer and colleagues (1) do not show any effect on erection by the addition of testosterone in men treated for ED with the PDE5 inhibitor sildenafil. The study is well-designed, but we believe that it misses some critical points that are milestones in the field.First, as stated in the Discussion section, an increase in testosterone levels of 3.47 nmol/L (100 ng/dL) occurred during the sildenafil run-in period alone. This is expected when a man with ED resumes sexual activity. Carosa and associates (2) suggested this finding by showing that the increase is not a direct effect ...References1. Spitzer M, Basaria S, Travison TG, Davda MN, Paley A, Cohen B, et al. Effect of testosterone replacement on response to sildenafil citrate in men with erectile dysfunction: a parallel, randomized trial. Ann Intern Med. 2012;157:681-91. [PMID: 23165659] LinkGoogle Scholar2. Carosa E, Martini P, Brandetti F, Di Stasi SM, Lombardo F, Lenzi A, et al. Type V phosphodiesterase inhibitor treatments for erectile dysfunction increase testosterone levels. Clin Endocrinol (Oxf). 2004;61:382-6. [PMID: 15355456] CrossrefMedlineGoogle Scholar3. Aversa A, Isidori AM, Spera G, Lenzi A, Fabbri A. Androgens improve cavernous vasodilation and response to sildenafil in patients with erectile dysfunction. Clin Endocrinol (Oxf). 2003;58:632-8. [PMID: 12699447] CrossrefMedlineGoogle Scholar4. Shabsigh R, Kaufman JM, Steidle C, Padma-Nathan H. Randomized study of testosterone gel as adjunctive therapy to sildenafil in hypogonadal men with erectile dysfunction who do not respond to sildenafil alone. J Urol. 2008;179:S97-S102. [PMID: 18405769] CrossrefMedlineGoogle Scholar5. Morelli A, Filippi S, Mancina R, Luconi M, Vignozzi L, Marini M, et al. Androgens regulate phosphodiesterase type 5 expression and functional activity in corpora cavernosa. Endocrinology. 2004;145:2253-63. [PMID: 14764637] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Sapienza University of Rome, Rome, Italy.Disclosures: Dr. Aversa: Consulting fee or honorarium: Bayer HealthCare, Eli Lilly. Dr. Jannini: Consulting fee or honorarium: Bayer HealthCare, Menarini. Dr. Maggi: Consulting fee or honorarium: Eli Lilly. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Testosterone Replacement on Response to Sildenafil Citrate in Men With Erectile Dysfunction Matthew Spitzer , Shehzad Basaria , Thomas G. Travison , Maithili N. Davda , Amanda Paley , Beth Cohen , Norman A. Mazer , Philip E. Knapp , Samson Hanka , Kishore M. Lakshman , Jagadish Ulloor , Anqi Zhang , Katie Orwoll , Richard Eder , Lauren Collins , Nurahmed Mohammed , Raymond C. Rosen , Leonard DeRogatis , and Shalender Bhasin Effects of Testosterone Replacement on Response to Sildenafil Citrate Matthew Spitzer , Shehzad Basaria , Thomas G. Travison , and Shalender Bhasin Effects of Testosterone Replacement on Response to Sildenafil Citrate Steven Smoger Effects of Testosterone Replacement on Response to Sildenafil Citrate Allen D. Seftel and Geoffrey Hackett Metrics Cited ByTargeting the NO‐cGMP‐PDE5 pathway in COVID‐19 infection. The DEDALO projectEuropean Academy of Andrology (EAA) guidelines on investigation, treatment and monitoring of functional hypogonadism in malesRole of Serum High-Sensitivity C-Reactive Protein as a Predictor of Therapeutic Response to Tadalafil in Patients With Erectile Dysfunction: A Prospective Observational StudyPhosphodiesterase Type 5 Inhibitors, Sport and DopingImpact of Baseline Total Testosterone Level on Successful Treatment of Sexual Dysfunction in Men Taking Once-Daily Tadalafil 5 mg for Lower Urinary Tract Symptoms and Benign Prostatic Hyperplasia: An Integrated Analysis of Three Randomized Controlled TrialsDoes testosterone supplementation increase PDE5-inhibitor responses in difficult-to-treat erectile dysfunction patients?Nonresponse to PDE5 inhibitors in erectile dysfunction. Part 2Testosterone Supplementation and Sexual Function: A Meta-Analysis StudySildenafil increases serum testosterone levels by a direct action on the testesWhich Is First? The Controversial Issue of Precedence in the Treatment of Male Sexual DysfunctionsSexual function of the ageing maleAn update on pharmacological treatment of erectile dysfunction with phosphodiesterase type 5 inhibitorsRisks and Benefits of Late Onset Hypogonadism Treatment: An Expert Opinion 2 April 2013Volume 158, Issue 7Page: 569-570KeywordsArteriesBlood plasmaConflicts of interestHealth careHuman sexual behaviorMotivationTestosteroneUltrasound imaging ePublished: 2 April 2013 Issue Published: 2 April 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...