Findings from a recent study published in BJU International Study have shown that long-acting testosterone undecanoate improved erectile dysfunction, intercourse satisfaction, and sexual desire scores in men with type 2 diabetes that have severe hypogonadism. 

For males with mild hypogonadism, only scores in sexual desire showed significant improvement with testosterone replacement therapy, noted the study’s lead author Professor Geoffrey Hackett, of the Heart of England Foundation NHS Trust, England.

Professor Hackett and colleagues aimed to evaluate sexual function response after treatment with long-acting testosterone undecanoate or placebo after 30 weeks (n=199). Enrolled patients in the randomized, placebo-controlled study were males with type 2 diabetes and either mild or severe hypogonadism. The men who completed the study (n=189) were first stratified by baseline total testosterone/free testosterone into mild or severe hypogonadism groups, then by treatment intervention. 

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Study authors compared changes in sexual function score at each visit with and between groups at assessments on Weeks 6, 18, and 30. They noted significant improvement in erectile dysfunction only in the severe hypogonadism group who were given testosterone undecanoate for 30 weeks. Scores for intercourse satisfaction and sexual desire also improved in the severe hypogonadism group following testosterone undecanoate therapy as assessed at Weeks 6, 18, and 30. Changes in orgasmic function were not observed in any of the study groups following treatment with testosterone undecanoate.

In general, benefits in sexual symptoms with testosterone undecanoate therapy were primarily seen in males with hypogonadism with total testosterone ≤8nmol/L and free testosterone ≤0.18nmol/L. Study findings support the duration of future trials on testosterone therapy to last at least 6 months “and not shorter periods as suggested by some guidelines,” Professor Hackett concluded.

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