title: Treatment of Men for "Low Testosterone": A Systematic Review.
abstract: Testosterone products are recommended by some prescribers in response to a diagnosis or presumption of "low testosterone" (low-T) for cardiovascular health, sexual function, muscle weakness or wasting, mood and behavior, and cognition. We performed a systematic review of 156 eligible randomized controlled trials in which testosterone was compared to placebo for one or more of these conditions. We included studies in bibliographic databases between January 1, 1950 and April 9, 2016, and excluded studies involving bodybuilding, contraceptive effectiveness, or treatment of any condition in women or children. Studies with multiple relevant endpoints were included in all relevant tables. Testosterone supplementation did not show consistent benefit for cardiovascular risk, sexual function, mood and behavior, or cognition. Studies that examined clinical cardiovascular endpoints have not favored testosterone therapy over placebo. Testosterone is ineffective in treating erectile dysfunction and controlled trials did not show a consistent effect on libido. Testosterone supplementation consistently increased muscle strength but did not have beneficial effects on physical function. Most studies on mood-related endpoints found no beneficial effect of testosterone treatment on personality, psychological well-being, or mood. The prescription of testosterone supplementation for low-T for cardiovascular health, sexual function, physical function, mood, or cognitive function is without support from randomized clinical trials.
authors.affiliation: Tulane University, School of Medicine, New Orleans, LA, United States of America.
authors.forename: Samantha
authors.initials: S
authors.lastname: Huo
authors.affiliation: Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States of America.|Scialli Consulting LLC, Washington, DC, United States of America.
authors.forename: Anthony R
authors.initials: AR
authors.lastname: Scialli
authors.affiliation: Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States of America.
authors.forename: Sean
authors.initials: S
authors.lastname: McGarvey
authors.affiliation: Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States of America.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hill
authors.affiliation: University of South Florida, Tampa, FL, United States of America.
authors.forename: Buğra
authors.initials: B
authors.lastname: Tügertimur
authors.affiliation: Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States of America.
authors.forename: Alycia
authors.initials: A
authors.lastname: Hogenmiller
authors.affiliation: University of Illinois, Chicago, IL, United States of America.
authors.forename: Alessandra I
authors.initials: AI
authors.lastname: Hirsch
authors.affiliation: Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States of America.
authors.forename: Adriane
authors.initials: A
authors.lastname: Fugh-Berman