Testosterone gel offers modest benefit for older men

Recent clinical trials have suggested that testosterone therapy could help in restoring some sexual desire in those older men whose natural level of hormones have decreased.

To test the potential benefit of testosterone treatment in men who had low levels of the hormone for no other reason than their advancing age, researchers investigated the effectiveness of testosterone gel for boosting their sexual function, physical function and vitality.

In 2003, an Institute of Medicine panel concluded that there was insufficient evidence that testosterone treatment was beneficial in older men, calling for more research into the issue. “We still don’t know everything we want to know”. The T Trials were created to determine if testosterone treatment would alleviate these symptoms. However, so far, there has never been a rigorous study that asked if there was any positive impact testosterone therapy for healthy men possessing so-called low T. A new study conducted by medical researchers at University of Pennsylvania has tried to find out the real positive impact of testosterone gels.

The TTrials were supported by a grant from the National Institute on Aging of the National Institutes of Health and funding from other institutes of the NIH.

Prof Thomas Gill, study co-author, said: “There appears to be benefits among men who have low levels of testosterone attributable exclusively to age”. Half received a placebo and half received testosterone treatments for a year.

One case of prostate cancer was documented among the 790 participants – a tiny number considering the men’s ages. “This is the first really well-designed and scientifically rigorous trial to get at the question of whether testosterone supplements provide benefit; we didn’t have that information before”. ABBVie Pharmaceuticals provided the testosterone booster gel for the research and partially funded the study. Efficacy was then evaluated at months three, six, nine and 12. “We showed that testosterone improved men’s impression that their sexual function and walking ability had improved, suggesting that these effects are clinically important”. The results on these outcomes are reported in the current paper.

A study conducted by UCLA in 2014 showed that men of ages 65 and above stood at double the risk of heart attacks within 90 days of starting testosterone treatment.

Men who had said their sexual functioning had been flagging reported moderate increases in their interest in sex and in their performance, although when it came to erections, a drug like Viagra or Cialis would be more effective, the researchers reported.

Among men who shared a similar low testosterone score, both the testosterone and the placebo participants showed comparable improvements during the walking test. However, when all participants were included in the results, 21 percent of the men using the testosterone treatment achieved the walking goal versus 13 percent of the placebo men. They also had slightly better improvements in mood and walking strength compared with those in placebo albeit the researchers found no difference in terms of energy boost. Men lured by advertisements seek the drug, and Dr. Khosla said he had heard of doctors who prescribed it without first measuring the man’s testosterone levels to see if they were low.

“There is considerable controversy about possible adverse effects of testosterone therapy in older men, and these studies do not resolve this controversy”, writes the author of an accompanying editorial. Dr. Morgentaler said research has discounted any link between elevated testosterone and prostate cancer. His part of the study ended two years ago, but Bostick is still taking testosterone. They found that testosterone treatment increased the blood testosterone level to mid-normal for young men.

The results of the latest trials “really help to put the effects of testosterone in some quantifiable context”, said Dr. Eric Orwoll, associate dean for clinical sciences at Oregon Health & Science University in Portland. And that, said Dr. Richard J. Hodes, the director of the National Institute on Aging, was deliberate.