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Question answered:15/02/06 Warning! this question is over two years old.
The NLH Q&A Service have answered a closely related question in 2005 [1]. This discusses the role of testosterone and the need to test for it in erectile dysfunction. The only UK guideline we know about was published in 1999 [2]. We have also located a number of overseas guidelines, published more recently [3].
You may be interested in a number of other sources of treatment advice. Clinical evidence has a chapter on erectile dysfunction [4] and Bandolier has a section dedicated to it [5]. The Bandolier section includes a recent paper on testosterone treatment [6], which has the following ‘Clinical bottom line’:
“There is limited evidence that testosterone can help men with erectile dysfunction. In five randomised comparisons with placebo with 109 men, testosterone was better than placebo in four, and the overall NNT was 2.1 (1.5 to 3.0). There is good evidence that testosterone supplementation works best in men with low initial serum testosterone concentrations below 12 nmol/L, and is ineffective in men with serum testosterone concentrations above this.
Information on trial quality is limited, and this result has insufficient weight to drive clinical practice.”
Your local NHS hospital may well have locally produced guidelines that deal with investigation and treatment of ED.
References
1) NLH Q&A Service. What role does testosterone play in erectile dysfunction? Should we test? 2005 (http://www.clinicalanswers.nhs.uk/index.cfm?question=855)
2) Erectile Dysfunction Alliance. Erectile dysfunction. 1999 (http://www.bashh.org/committees/sig/dys_sig/edguidelines.pdf)
3) NLH Q&A Service. Where can I find the most up-to-date, authoritative guidelines on the investigation of a newly-presenting male with erectile dysfunction? 2005 (http://www.clinicalanswers.nhs.uk/index.cfm?question=1007)
4) Clinical Evidence. Erectile dysfunction. 2003 (http://www.clinicalevidence.com/ceweb/conditions/msh/1803/1803.jsp)
5) Bandolier. Erectile dysfunction and premature ejaculation. (http://www.jr2.ox.ac.uk/bandolier/booth/booths/erect.html)
6) Bandolier. Testosterone for erectile dysfunction. 2005 (http://www.jr2.ox.ac.uk/bandolier/booth/SexHlth/testo.html)
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