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Viagra Not Working? Maybe This Gel Will Help!
Men With Sexual
Dysfunction Should Be Screened For Low Testosterone
Aug. 4, 2004 – Viagra not working well enough for
you? Now another drug-maker wants to sell you a testosterone gel (AndroGel)
that enhances erectile function and sexual satisfaction even more for
those with low testosterone.
It is estimated that four to five million American
men have low testosterone, including one in ten men between the ages of
40 and 60. Low testosterone – also known as hpypognadism or “low T” -
may lead to decreased libido, erectile dysfunction, osteoporosis,
reduced lean body mass, depressed mood and fatigue. Men with low
testosterone may find Viagra ineffective.
The large number of men who suffer from this
dysfunction has caused tremendous demand for drugs like Viagra (sildenafil)
to help improve sexual interest and performance. This new study promises
even better results with the addition of the gel.
Dr. Ridwan Shabsigh, associate professor of urology
at Columbia University College of Physicians & Surgeons and director of
the New York Center for Human Sexuality at NewYork-Presbyterian
Hospital/Columbia was the lead investigator in the study, which is
published in the August issue of the Journal of Urology.
"Our data support the potential benefits of a
combination therapy with testosterone gel for men with erectile
dysfunction and low testosterone who find sildenafil by itself
ineffective," said Dr. Shabsigh. "When assessing erectile dysfunction,
doctors and patients should consider using a simple blood test to
determine if low testosterone is a contributing factor. If the root
cause is low testosterone, sildenafil alone won't fix the problem."
Sildenafil enhances the effects of nitric oxide, a
chemical in the body that allows increased blood flow to the penis
during sexual stimulation. "Research suggests nitric oxide may be
dependent on testosterone to function properly," said Dr. Shabsigh.
"While further studies are needed, this concept may explain why
testosterone replacement therapy could help hypogonadal men who do not
respond to sildenafil."
In the trial, 75 hypogonadal men (18 to 80 years
old) were randomized to testosterone gel plus sildenafil versus placebo
plus sildenafil. Participants were in a stable heterosexual
relationship. Ninety-one percent had experienced erectile dysfunction
for at least one year prior to the study. All participants had
testosterone levels in the low to low/normal range (< 400ng/dL) and had
failed to respond to 100mg doses of sildenafil, based on questions from
the International Index of Erectile Function (IIEF) scale.
Analysis of 70 men at four weeks found the
population randomized to receive a daily dosage of 5mg testosterone gel
in addition to a 100mg sildenafil (n = 37) taken as needed, had a
significantly improved response to treatment, when compared to those on
100mg sildenafil plus a placebo (n = 33). Results of the Erectile
Function Domain, Orgasmic Function Domain, Overall Satisfaction and
Total Score on the IIEF were used to compare the groups. For Erectile
Function Domain, the men receiving testosterone gel reported an average
increase double those receiving a placebo, with a 34 percent and 17
percent improvement from baseline, respectively.
On average, participants in the testosterone gel
group reported a 28 percent increase from baseline in Orgasmic Function
Domain compared to a 4 percent improvement in the placebo group, after
four weeks of treatment. Overall Satisfaction improved 32 percent in the
testosterone gel group, compared to 10 percent in the placebo group. The
results at eight and twelve weeks showed a trend in favor of
testosterone gel compared to placebo, but no statistical significance.
Viagra is manufactured by Pfizer Inc. and AndroGel
is made by Unimed Pharmaceuticals, Inc., a Solvay Pharmaceuticals, Inc.
company
Dr. Shabsigh is the author of "Back to Great Sex:
Overcome E.D. and Reclaim Lost Intimacy," a book developed to help men
with erectile dysfunction communicate effectively with their physicians.
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