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References - Erection Problems

Carruthers, M. Beyond Viagra: Combining testosterone and sildenafil for the treatment of erectile dysfunction. (1998) Lecture given by invitation at the Annual Fall Conference, Broda O. Barnes, MD Research Foundation Inc. October 2-4, Stamford, Connecticut.Conference Proceedings Abstract Objective To establish the effectiveness of the treatment of erectile dysfunction with testosterone alone, or combined with sildenafil. Design Cross-sectional survey of a group of 668 men presenting at a private clinic with andropausal symptoms, including erectile dysfunction. After full assessment, including a checklist of symptoms and endocrine profile, they took part in a prospective trial of three different forms of androgen treatment, which was combined with sildenafil in 100 cases. Results The men were aged 31-91 (mean 59) and varying degrees of erectile dysfunction were present in 85%, with reduced libido in 79%. Overall, testosterone treatment alone improved the ability to obtain and maintain an erection in 65% and 52% respectively, and libido in 69% of cases, while also producing significant and sustained improvements in all the other symptoms. Of the 100 men treated with sildenafil in combination with testosterone, erectile function was restored in 98% and libido in 95%. Conclusions The andropause is associated with an absolute or relative lack of testosterone, and its characteristic symptoms, including erectile dysfunction and reduced libido, can and should be treated with hormone replacement therapy. Only after screening for, and where frequently necessary correcting, the underlying androgen deficiency should sildenafil be given, where it is often needed in low and infrequent doses, with consequent increase in safety and reduction in costs.

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