Association of sex hormones with sexual function, vitality, and physical function of symptomatic older men with low testosterone levels at baseline in the testosterone trials

J Clin Endocrinol Metab. 2015 Mar;100(3):1146-55. doi: 10.1210/jc.2014-3818. Epub 2014 Dec 30.


Context: The prevalence of sexual dysfunction, low vitality, and poor physical function increases with aging, as does the prevalence of low total and free testosterone (TT and FT) levels. However, the relationship between sex hormones and age-related alterations in older men is not clear.

Objective: To test the hypotheses that baseline serum TT, FT, estradiol (E2), and sex hormone-binding globulin (SHBG) levels are independently associated with sexual function, vitality, and physical function in older symptomatic men with low testosterone levels participating in the Testosterone Trials (TTrials).

Design: Cross-sectional study of baseline measures in the TTrials.

Setting: The study was conducted at 12 sites in the United States.

Participants: The 788 TTrials participants were ≥ 65 years and had evidence of sexual dysfunction, diminished vitality, and/or mobility disability, and an average of two TT < 275 ng/dL.

Interventions: None.

Main outcome measures: Question 4 of Psychosocial Daily Questionnaire (PDQ-Q4), the FACIT-Fatigue Scale, and the 6-minute walk test.

Results: Baseline serum TT and FT, but not E2 or SHBG levels had small, but statistically significant associations with validated measures of sexual desire, erectile function, and sexual activity. None of these hormones was significantly associated within or across trials with FACIT-Fatigue, PHQ-9 Depression or Physical Function-10 scores, or gait speed.

Conclusions: FT and TT levels were consistently, independently, and positively associated, albeit to a small degree, with measures of sexual desire, erectile function, and sexual activity, but not with measures of vitality or physical function in symptomatic older men with low T who qualified for the TTrials.

Trial registration: NCT00799617.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Erectile Dysfunction / drug therapy
  • Erectile Dysfunction / epidemiology
  • Gait / physiology
  • Gonadal Steroid Hormones / blood*
  • Hormone Replacement Therapy
  • Humans
  • Hypopituitarism / blood
  • Hypopituitarism / drug therapy*
  • Hypopituitarism / physiopathology
  • Hypopituitarism / psychology
  • Libido / physiology
  • Male
  • Motor Activity / physiology*
  • Quality of Life / psychology
  • Sexual Behavior*
  • Surveys and Questionnaires
  • Testosterone / deficiency*
  • Testosterone / therapeutic use*
  • United States / epidemiology


  • Gonadal Steroid Hormones
  • Testosterone

Associated data