title: Effect of transdermal testosterone or alpha-lipoic acid on erectile dysfunction and quality of life in patients with type 2 diabetes mellitus.
abstract: Erectile dysfunction (ED) is the inability to develop and/or maintain an erection that is sufficient for satisfactory sexual intercourse. The prevalence of erectile dysfunction in diabetic men is 28-75%, this percentage rising with patient's age and duration of diabetes. The AIM of the present study was to investigate erectile dysfunction and quality of life in patients with type 2 diabetes mellitus (T2DM) after treating them with transdermal testosterone or with alpha-lipoic acid.
  
  
  METHODS
  The effect of a 12-week treatment with transdermal testosterone or alpha-lipoic acid on the erectile function and quality of life of 45 men with ED and T2DM was studied in a randomized, prospective, open clinical, comparative study. The parameters we measured in the patients were body weight and body mass index (BMI); the albumin, lipids, HbA1C, testosterone (T), sex hormone-binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH) and microalbuminuria levels; the International Index of Erectile Function (IIEF) and Health related quality of life (SF-36) questionnaires were completed to evaluate ED and quality of life before and after 12 weeks of treatment with alpha-lipoic acid (600 mg, parenterally, for 7 days, followed by 600 mg received per os) or with transdermal testosterone in a dose of 50 mg daily.
  
  
  RESULTS
  Testosterone treatment decreased BMI significantly (p < 0.01), increased testosterone concentrations (p < 0.01) and raised the SHBG levels (p < 0.05), improved the glycemic control and lipid profile (total cholesterol, p < 0.05; HDL cholesterol, p < 0.05; triglycerides, p < 0.05). The patients treated with alpha-lipoic acid had their BMI (p < 0.01), HbA1C (p < 0.01), total cholesterol (p < 0.01), HDL-cholesterol (p < 0.01) and triglycerides (p < 0.01) significantly reduced. The indicators for ED in both groups were also statistically significantly improved. There was improvement for all patients' self-assessment score for "physical functioning" (p = 0.001), for "role limitations due to physical health" (p < 0.001) and for "general health perception" (p = 0.021).
  
  
  CONCLUSIONS
  Transdermal testosterone and alpha-lipoic acid have a tangible beneficial effect on erectile dysfunction and on metabolic disorders in T2DM patients and can be used to treat such patients.
authors.affiliation: Clinic of Endocrinology and Metabolic Disorders, Medical University, Plovdiv, Bulgaria. mitkov@yahoo.com
authors.forename: Mitko D
authors.initials: MD
authors.lastname: Mitkov
authors.forename: Ivanka Y
authors.initials: IY
authors.lastname: Aleksandrova
authors.forename: Maria M
authors.initials: MM
authors.lastname: Orbetzova
mesh_terms: D000279:Administration, Cutaneous; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000523:psychology; D007172:Erectile Dysfunction / Q000188:drug therapy*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000008:administration & dosage*; D008063:Thioctic Acid / Q000627:therapeutic use
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D008063:Thioctic Acid; D007986:Luteinizing Hormone