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The role of testosterone in sexual performance has been of interest to researchers for some time. The key reason for this has been that it has not been uncommon for men with erectile dysfunction to also exhibit low testosterone levels. Now a recent study suggests that adding testosterone to sidenafil treatment (Viagra) is unlikely to improve sexual erections or sexual performance

The study, which was a randomised trial, included a total of 140 men between the ages of 40 and 70 who exhibited erectile dysfunction and low testosterone levels. Once their sidenafil treatment was optimised, the participants were given a transdermal gel and told to apply it daily. The gel contained either 5 or 15 mg of testosterone, or was a placebo and the researchers assessed the participants after 14 weeks. Although both groups reported improvement in sexual function, there were no significant differences in the extent of these improvements between groups. These effects were not affected by the participants’ age, response to sidenafil or pre-treatment testosterone levels. Based on this, the researchers concluded that the use of sidenafil could account for the reported improvements.

Overall, the trial had a good design and extended over a period of time that is likely to have been sufficient to find changes between the groups. Perhaps most importantly the study brought with it findings whose implications extend to both treatment and research. It is now key to determine whether testosterone and sidenafil share common mechanistic pathways as this could indicate whether there are times when testosterone should be used on it own, or whether there is a possibility for testosterone to complement other treatments for erectile dysfunction. 

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