MEN
July 15, 2015

Low T? Not Necessarily

Testosterone may not be the answer for men with ejaculation problems.

For men with ejaculation problems, testosterone does not seem to be the answer. Men who underwent a 16-week course of testosterone replacement therapy showed no significant improvement in symptoms, according to a randomized controlled study.

Between 10 and 18 percent of men have problems with ejaculation. These range from an inability to ejaculate, decreased volume of ejaculation, decreased force of ejaculation and delayed time to ejaculation.

Ejaculation difficulties are different from erectile dysfunction, though they can be just as frustrating. And unfortunately, there is no FDA-approved little blue pill for ejaculation problems.

This study looked at men 26 or older who had at least one of the ejaculation problems mentioned above. They also had low testosterone levels, measuring under 300 ng/dL on two separate occasions. The idea was to see whether testosterone supplementation might be helpful.

There is no FDA-approved treatment for ejaculation problems, no little blue pill.

Half of the men applied a 2% testosterone solution (60 mg) to their skin daily, while the other half applied placebo. Four weeks into the study, men whose testosterone level was still under 300 ng/dL had their dose increased by 50%, while those with a testosterone level over 1050 ng/dL had their dose cut in half. These doses were maintained until the end of the 16-week study.

The men completed sexual health questionnaires and had semen samples analyzed. The researchers found no or little improvement in ejaculate volume or orgasmic function, which led them to conclude that men with ejaculation difficulties and the doctors who are treating them should look for reasons other than testosterone level for the source of these problems.

“Our findings suggest physicians who are treating men with ejaculatory dysfunction need to look at other reasons for delayed ejaculation than hypogonadism,” said Shehzad Basaria, MD, of Brigham and Women's Hospital and Harvard Medical School, one of the study's authors. “More research is needed to determine whether a longer course of testosterone therapy or other treatment options can benefit men with ejaculatory dysfunction.”

In a statement accompanying the study, the authors suggest that testosterone may help certain men with ejaculation problems. In their study, testosterone replacement only boosted serum testosterone levels above 300 ng/dL in about 70% of the men who received it. In a subsequent analysis, these men did show a statistically significant improvement in ejaculatory function when compared to men whose testosterone levels did not reach that threshold.

More research will be needed to determine if a longer course of testosterone therapy or other modifications of the therapy can benefit men with ejaculatory dysfunction, the authors say. But for now, they suggest looking elsewhere for relief.

The study appears in the Journal of Clinical Endocrinology & Metabolism and is freely available.

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