Editing Testosterone Deficiency (2018) (section)

====== Testosterone therapy for erectile dysfunction ======
* The role of testosterone therapy as a monotherapy for ED is less clear.
* Combination therapy with phosphodiesterase type 5 inhibitors (PDE5-I) and TT is a highly debated topic. When erection is restored by PDE5-I, the addition of TT does not result in further benefit of erectile function. For ED refractory to PDE5-I, TT has the potential to improve the efficacy of therapy only in men with biochemical AD (<300 ng/dL).
** '''In young men with symptomatic AD, testosterone therapy should be the first-line treatment with high likelihood of improvement in all domains of sexual function, and PDE5-I can be added if necessary.'''
** '''In elderly men with ED, PDE5-I should be first-line therapy with optimization of comorbid conditions.''' In the case of nonresponders, TT should be reserved only in men with biochemical confirmation of AD.