Symptomatic response rates to testosterone therapy and the likelihood of completing 12 months of therapy in clinical practice

J Sex Med. 2010 Jan;7(1 Pt 1):277-83. doi: 10.1111/j.1743-6109.2009.01544.x.


Introduction: Despite increasing medical interest in testosterone therapy (TTh) for men with testosterone deficiency (TD) there is limited information regarding subjective response rates and acceptability of medium- to long-term TTh in routine clinical practice.

Aim: To evaluate results in a consecutive series of men in clinical practice treated with TTh.

Material and methods: A chart review was performed for a consecutive series of men for whom TTh was initiated over 1 year for a clinical diagnosis of TD. A diagnosis of TD was based on the presence of symptoms and on laboratory evaluation indicating total testosterone (<300 ng/dL) or free testosterone (FT) (<1.5 ng/dL). Presenting symptoms were noted at baseline, and improvement was documented in domains of erectile function, libido, energy,and mood.

Main outcome measures: Percentage of men who completed 12 months of TTh, and symptomatic response rates.

Results: There were 127 men included in the evaluation. The most common presenting symptoms were the combination of erectile dysfunction (ED) and reduced libido in 82 (64.6%), ED alone in 29 (22.8%), and reduced libido alone in 13 (10.2%). Initial mode of TTh was injections (testosterone enanthate or cypionate) in 70 (55.1%)and transdermal gel (Androgel, Solvay Pharmaceuticals, Marietta, GA, USA) in the remainder. Improvements in erections, libido, energy, and/or mood were reported by 70% of men by 3 months. Eighty men (63%) completed 12 months of TTh with subjective benefit (responders). Treatment was discontinued in 34 (26.8%) who reported no major benefit (non-responders), and 13 (10.2%) were lost to follow-up. Among men who discontinued TTh, 64.7%failed to report benefits by 3 months. Baseline FT was lower among responders than non-responders. One case(1.25%) of prostate cancer was identified after one year of TTh.

Conclusion: Approximately two-thirds of men with TD who begin TTh will experience symptomatic benefit and will complete at least 12 months of treatment. Benefit was noted in a majority by 3 months.

MeSH terms

  • Administration, Cutaneous
  • Adult
  • Aged
  • Delayed-Action Preparations
  • Erectile Dysfunction / drug therapy*
  • Follow-Up Studies
  • Hormone Replacement Therapy / psychology*
  • Humans
  • Hypogonadism / blood
  • Hypogonadism / drug therapy*
  • Injections
  • Libido / drug effects*
  • Likelihood Functions
  • Long-Term Care
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Retrospective Studies
  • Testosterone / administration & dosage*
  • Testosterone / adverse effects
  • Testosterone / analogs & derivatives*
  • Testosterone / blood


  • Delayed-Action Preparations
  • Testosterone
  • testosterone enanthate
  • testosterone 17 beta-cypionate