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Male erectile function (von Französisch in Englisch)

13. Discussion and Conclusions

This study reports the effects of percutaneous administration of a non-aromatizable androgen on sexual disorders associated with a moderate hypogonadal condition in adult men. It was a comparative, monocentric study conducted on two groups and randomized in double blind.

All patients were recruited in the endocrinological clinic for an erectile dysfunction, associated in more than 75% of the cases with a paucity of nocturnal erections and a diminution of libido. Hormonal investigation of these men led to their inclusion in the study when the assay for testosterone not bound to SBP showed a value below the lower limit of the normal range, i.e. 65 ng/dl for men 20 to 40 years old.

On the basis of this criterion of moderate hypogonadism, 24 men 37 to 65 years old agreed to participate in the study and gave their consent.

After said inclusion visit, lots were drawn for a sequence of either hormonal treatment followed by placebo or placebo followed by hormonal treatment. Each sequence lasted two months. At the end of each sequence, hospitalization in the night hospital enabled a clinical examination, a self-assessment of sexual activity by questionnaire, and plethysmography with nocturnal recording to be made, followed the next morning by a biological control on an empty stomach.

For the interpretation of plethysmography, only those patients were selected whose quality of sleep did not interfere with the number of tumescences of the base or tip of the penis and with the measurement of rigidity. Thus, it was possible to study a subpopulation of 14 patients under proper conditions.

The percutaneous administration of dihydrotestosterone is accompanied by a significant increase in the number of erections recorded at the tip of the penis (3.1 +/- 0.4 versus 4.6 +/- 0.4; p = 0.0014) and to a lesser degree the number of erections recorded at the base (3.8 +/- 0.5 versus 4.9 +/- 0.5; p = 0.12). However, no modifications of rigidity were observed on interpretation of plethysmography performed either visually or by computer, after transfer of the plethysmographic recording data to a micro-computer.