Cochrane · systematic review · CD013071
Testosterone replacement in men with sexual dysfunction
Lee, H, Hwang, EC, Oh, CK, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
26
current version
GRADE rated
17
No studies
9
Included studies
NR
No studies 9 · 34.6%Ungraded 0 · 0%Very low 6 · 23.1%Low 3 · 11.5%Moderate 8 · 30.8%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Testosterone compared to placebo in men with sexual dysfunction (short‐term: sensitivity analysis)
Population: men with sexual dysfunction
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erectile function Testosterone vs placebo | no estimate extracted | 3 studies · 792 participants | Moderate Downgraded: indirectness |
Erectile function Testosterone vs placebo | no estimate extracted | 6 studies · 2016 participants | Moderate Downgraded: indirectness |
Sexual quality of life Testosterone vs placebo | no estimate extracted | 5 studies · 1030 participants | Moderate Downgraded: indirectness |
Sexual quality of life Testosterone vs placebo | no estimate extracted | 2 studies · 786 participants | Moderate Downgraded: indirectness |
Cardiovascular mortality Testosterone vs placebo | RR 0.83 [0.21, 3.26] | 10 studies · 3525 participants | Moderate Downgraded: indirectness |
Treatment withdrawal due to adverse events Testosterone vs placebo | RR 0.81 [0.56, 1.19] | 12 studies · 2966 participants | Moderate Downgraded: indirectness |
Prostate‐related events: Testosterone vs placebo | RR 1.65 [1.08, 2.51] | 10 studies · 3439 participants | Moderate Downgraded: indirectness |
Lower urinary tract symptoms Testosterone vs placebo | no estimate extracted | 6 studies · 1488 participants | Moderate Downgraded: indirectness |
Testosterone compared to placebo in men with sexual dysfunction (long‐term)
Population: men with sexual dysfunction
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erectile function Testosterone vs placebo | no estimate extracted | 1 study · 42 participants | Very low Downgraded: risk of bias |
Sexual quality of life Testosterone vs placebo | no estimate extracted | NR | No studies |
Cardiovascular mortality Testosterone vs placebo | no estimate extracted | NR | No studies |
Treatment withdrawal due to adverse events Testosterone vs placebo | RR 1.04 [0.58, 1.86] | 2 studies · 122 participants | Very low Downgraded: risk of bias |
Prostate‐related events Testosterone vs placebo | no estimate extracted | NR | No studies |
Lower urinary tract symptoms Testosterone vs placebo | no estimate extracted | NR | No studies |
Testosterone compared to PDE5I in men with sexual dysfunction (short‐term)
Population: men with sexual dysfunction
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erectile function Testosterone vs PDE5I | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias |
Sexual quality of life Testosterone vs PDE5I | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias |
Cardiovascular mortality Testosterone vs PDE5I | no estimate extracted | NR | No studies |
Treatment withdrawal due to adverse events Testosterone vs PDE5I | no estimate extracted | NR | No studies |
Prostate‐related events Testosterone vs PDE5I | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias |
Lower urinary tract symptoms Testosterone vs PDE5I | no estimate extracted | NR | No studies |
Testosterone as an add‐on to PDE5I compared to PDE5I alone in men with sexual dysfunction (short‐term)
Population: men with sexual dysfunction
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Erectile function (conversion to IIEF‐EF) Testosterone as an add‐on to PDE5I vs PDE5I alone | no estimate extracted | 4 studies · 430 participants | Low Downgraded: risk of bias |
Sexual quality of life Testosterone as an add‐on to PDE5I vs PDE5I alone | no estimate extracted | 2 studies · 282 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Cardiovascular mortality Testosterone as an add‐on to PDE5I vs PDE5I alone | no estimate extracted | NR | No studies |
Treatment withdrawal due to adverse events Testosterone as an add‐on to PDE5I vs PDE5I alone | RR 1.26 [0.32, 4.91] | 3 studies · 388 participants | Low Downgraded: risk of bias |
Prostate‐related events Testosterone as an add‐on to PDE5I vs PDE5I alone | RR 6.83 [0.84, 55.37] | 3 studies · 373 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Lower urinary tract symptoms Testosterone as an add‐on to PDE5I vs PDE5I alone | no estimate extracted | NR | No studies |