Testosterone replacement therapy using long-acting testosterone undecanoate (TU) improved several sexual function domains in men with type 2 diabetes, British researchers have shown.
Diabetic men are prone to sexual problems, especially erectile dysfunction and hypogonadism (low testosterone). The researchers set out to compare treatment with TU with that of a placebo in terms of sexual function, mood, and quality of life in men with diabetes.
The participants were men over age 18 (mean age 62) who had been diagnosed with diabetes after a routine assessment in a United Kingdom clinic. They were referred to the study by their primary care physicians. To officially diagnose hypogonadism, testosterone levels were measured two weeks before the start of the study and at the official start. Symptoms were also evaluated using the Ageing Male Symptom (AMS) assessment.
The study took place in two parts. In the first segment, 199 men were randomly assigned to receive 30 weeks of treatment with TU or a placebo. Both substances were given as injections to the buttock at week 0, week 6, and week 18.
At 30 weeks, men were given the option to participate for another 52 weeks in an open-label study segment. One hundred six of the original 199 men chose to do this.
The International Index of Erectile Function (IIEF) served as the primary outcome measure for sexual function. To assess mood and quality of life, the researchers used the AMS, the Hospital Anxiety and Depression Scale (HADS), and the Global Efficacy Question (GEQ).
Key Findings: Testosterone Replacement Therapy & Type 2 Diabetes
Key findings included the following:
- At 30 weeks, TU treatment improved all domains of sexual function: erectile function, intercourse satisfaction, desire, overall satisfaction, and orgasm. Some men started seeing improvement after six weeks of treatment.
- For a small group of men who took phosphodiesterase type 5 inhibitors, improvement was not seen until the second segment of the study.
- At 30 weeks, 46% of the men taking TU felt that their health had improved because of the treatment, compared to 17% of the placebo group. At the end of the open-label segment, 70% of all participants said their health had improved.
- Obese men and those with depression had “diminished response.”
- Less obese men and older men saw more benefit.
No serious adverse events were reported. Some men experienced pain during the injections.
The authors encouraged healthcare providers to screen for hypogonadism and depression in men with type 2 diabetes, as testosterone therapy may improve sexual function and mood for these men, improving overall quality of life.
The study was published online in April in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
Hackett, Geoffrey, MD, et al.
“Testosterone Replacement Therapy with Long-Acting Testosterone Undecanoate Improves Sexual Function and Quality-of-Life Parameters vs. Placebo in a Population of Men with Type 2 Diabetes”
(Full-text. First published online: April 3, 2013)