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In obese hypogonadal men, long-term testosterone therapy improves erectile function, quality of life and body weight – real-life evidence from a registry study

Saad, F1Haider, A2; Haider, KS2; Doros, G3; Traish, A4

1: Bayer AG, Germany; 2: Private Urology Practice, Germany; 3: Boston University School of Public Health, USA; 4: Boston University School of Medicine, USA

Objectives: Obesity has negative effects on erectile function. We investigated effects of long-term testosterone therapy (TTh) in a registry in a urology office in comparison to an untreated hypogonadal control group.

Material and Methods: Of 776 hypogonadal men in the registry, 441 (59%) were obese. 267 obese men with testosterone ≤12.1 nmol/L and symptoms of hypogonadism received testosterone undecanoate 1000 mg every 3 months following an initial 6-week interval for up to 10 years (T-group). 174 hypogonadal men decided against testosterone therapy (CTRL). Erectile function was assessed by IIEF-EF (5+1 questions, maximal score: 30). Differences between groups were estimated and adjusted for age, waist circumference, BMI, blood pressure, lipids, and quality of life to account for baseline differences between groups.

Results: Mean age: T-group: 60±6, CTRL: 64±5. IIEF-EF increased from 19.1±5.2 to 27.1±1.6 at 10 years in the T-group. The improvement was statistically significant compared to previous year for the first 5 years. In CTRL, IIEF-EF decreased from 19.4±3.6 to 9±2 with statistical significance vs. previous year for the first 9 years. The estimated adjusted between-group difference was +19.2 (p<0.0001 for all). Quality of life (QoL), measured by the Aging Males’ Symptoms scale, improved in the T-group from 52.2±10 to 17.1±0.2 and declined in CTRL from 39.8±5.6 to 58±2, estimated adjusted between-group difference: 40.4 (p<0.0001 for all). Waist circumference decreased from 110±7 to 98±6 cm in the T-group (p<0.0001) and from 118±11 to 114±10 in CTRL (NS), estimated difference between groups: -14 cm (p<0.0001). Weight decreased from 113±11 to 89±8 kg in the T-group (p<0.0001) and from 104±9 to 100±9 in CTRL (NS), between-group difference: -23 kg (p<0.0001). The per cent weight change at 10 years was -21.3±4.9% in the T-group (p<0.0001) vs +0.3±5.1% in CTRL (p<0.01), between-group difference: -21.3% (p<0.0001). Medication adherence in the T-group was 100 per cent as all injections were performed in the office and documented.

Conclusions: Erectile function improved with long-term TTh but worsened in CTRL. Weight and waist circumference decreased sustainably in the T-group and remained largely stable in CTRL. Weight loss as a result of TTh in obese hypogonadal men may have contributed to improving sexual function. Changes in erectile function and body weight were accompanied by changes in quality of life.


Work supported by industry: yes, by Bayer AG (industry funding only - investigator initiated and executed study).

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