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This version published online on April 12, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0247
A more recent version of this article appeared on July 1, 2005
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Submitted on February 3, 2005
Accepted on April 5, 2005

Dose-Dependent Effects of Testosterone on Sexual Function, Mood and Visuospatial Cognition in Older Men

Peter B. Gray, Atam B. Singh, Linda J. Woodhouse, Thomas W. Storer, Richard Casaburi, Jeanne Dzekov, Connie Dzekov, Indrani Sinha-Hikim, and Shalender Bhasin*

Charles Drew University, Division of Endocrinology, 1731 East 120Street, Los Angeles, CA, 90059

* To whom correspondence should be addressed. E-mail: sbhasin{at}ucla.edu.

Context. The relationships between testosterone dose and its effects on sexual function, mood, and visuospatial cognition are poorly understood.

Objective. To elucidate testosterone dose-response relationships in older men, we examined the effects of graded testosterone doses on sexual function, mood and visuospatial cognition in healthy, older men (60-75 yr).

Setting. General Clinical Research Center

Intervention/Methods. Subjects each received a long-acting GnRH agonist to suppress endogenous testosterone production, and were randomized to receive one of five doses (25, 50, 125, 300 and 600 mg) of testosterone enanthate given weekly for 20 weeks. Questionnaires were used to evaluate sexual function. Scores for overall sexual function, as well as sub-components of sexual function (libido, sexual activity and erectile function) were calculated.

Results. Changes in overall sexual function (P = 0.003) and waking erections (P = 0.024) differed by dose. An interaction between libido and being sexually active was observed such that libido changed by testosterone dose only among men reporting being sexually active at the beginning of the study (P = 0.009). Men's log-transformed free testosterone levels during treatment were positively correlated with overall sexual function (P = 0.001), waking erections (P = 0.040), spontaneous erections (P = 0.047) and libido (P = 0.027) but not intercourse frequency (P = 0.428) or masturbation frequency (P = 0.814). No effects of testosterone dose were observed on two measures of mood: Hamilton's Depression Inventory (P = 0.359) and Young's Mania Scale (P = 0.851). Number of trials completed on a computer-based test of visuospatial cognition differed by dose (P = 0.042), but number of squares correctly completed on this task did not differ by dose (P = 0.159).

Conclusions. Different aspects of male behavior respond differently to testosterone. When considered together with previous data from young men, these data indicate that testosterone dose-response relationships for sexual function and visuospatial cognition differ in older and young men.
Key words: Androgens • sexual behavior • libido • depression • spatial cognition • aging




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