What Is the Treatment of Impotence of Organic Origin with Testosterone Deficiency (Serum Total Testosterone <300 ng/dL)?

This protocol applies to men presenting with erectile dysfunction in whom serum total testosterone measurement confirms testosterone deficiency — defined as a total testosterone level below 300 ng/dL together with clinical symptoms and signs of deficiency.

Clinical scenario

        Testosterone deficiency confirmed on serum testing is a clinically relevant finding in men with difficulty achieving or maintaining an erection. Current evidence indicates that serum total testosterone should be measured in all men with erectile dysfunction to identify testosterone deficiency (TD), defined as total testosterone below 300 ng/dL with the presence of symptoms and signs.
      

Approach

The protocol involves testosterone therapy as a central component of management. The full combination approach — including the specific co-administered agent and its role in optimising outcomes — is detailed in the structured regimen.

Goal: penile erection sufficient for satisfactory sexual performance

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.juro.2018.05.004

Serum total testosterone should be measured in all men with ED to determine if testosterone deficiency (TD), defined as total testosterone <300 ng/dL with the presence of symptoms and signs, is present.

Men with ED and testosterone deficiency (TD) who are considering ED treatment with a PDE5i should be informed that PDE5i may be more effective if combined with testosterone therapy.

If a man with ED is also diagnosed with TD, then he should be counseled that testosterone therapy in combination with a PDE5i is more likely to be effective than the PDE5i alone.

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