Testosterone Deficiency and Erectile Dysfunction: A Practical Approach to Diagnosis and Management - Abstract
Testosterone deficiency syndrome (TDS) is a clinical and biochemical syndrome frequently associated with age and co-morbidities and is characterized by deficiency in testosterone and relevant androgen-deficiency symptoms. The main physiological action of testosterone in male sexual function is in sexual desire by regulating the timing of the penile erectile with sex. However sexual dysfunction associated with TDS also includes erectile dysfunction (ED) and delayed ejaculation. The link between ED, testosterone deficiency and cardiovascular disorders is well documented. The recommended tests for men with ED include fasting glucose, cholesterol, lipids and testosterone level. Both ED and TDS are treatable conditions. A range of testosterone preparations are available for supplementation, and the combination of testosterone replacement therapy and phosphodiesterase type 5 inhibitors might improve outcomes in some cases. The selection of the testosterone replacement therapy should be a joint decision between an informed patient and his primary care physician, and regular follow-up should be conducted to assess treatment efficacy and surveillance for adverse events.