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The effect of topically applied vasoactive agents and testosterone versus testosterone in the treatment of erectile dysfunction in aged men with low sexual interest

International Journal of Impotence Research volume 13, pages 93–98 (2001)Cite this article

Abstract

The objective was to evaluate the efficacy and safety of topically applied cream containing testosterone, isosorbide dinitrate and co-dergocrine mesylate compared to testosterone cream in the treatment of erectile dysfunction in aged men with low sexual interest. A randomised double-blind crossover trial was performed over two months. The subjects were 42 men with erectile dysfunction and low normal or slightly depressed testosterone level randomly allocated to two equal groups. Polypharmacy cream containing testosterone 0.8%, isosorbide dinitrate 0.5% and co-dergocrine mesylate 0.06% was applied for one month, and testosterone 0.8% cream for another month. The serum level of total testosterone was measured before and after each phase of treatment. Response to each therapy was assessed by a sexual questionnaire, measurement of tumescence and repeat penile duplex ultrasonography. Twenty-eight patients reported full erection and satisfactory intercourse with the polypharmacy cream. Thirteen men reported full erection and satisfactory intercourse with either cream. Polypharmacy cream increased penile arterial flow (P<0.001) and induced tumescence in 34 patients in lab. No patient in either phase of the study has tumescence or a significant increase in cavernous arterial peak systolic velocities after the application of testosterone cream. Serum level of total testosterone increased in all patients (P<0.05). Sexual desire was improved in 85% and 62% of patients during the treatment with polypharmacy cream and testosterone cream, respectively. No marked side effects were reported after either of them. Topical treatment with cream containing testosterone and vasoactive agents may represent a new effective treatment for erectile dysfunction associating with aging.

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References

  1. Feldman HA et al.Impotence and its medical and psychosocial correlates: results of the Massachusetts male aging study. J Urol 1994 151, 54–61.

    Article  CAS  Google Scholar 

  2. Vermeulen A. . Clinical review 24: androgens in the aging male. J Clin Endocrinol Metab 1991 73, 221–224.

    Article  CAS  Google Scholar 

  3. Gray A, Feldman HA, McKinlay JB, Longcope C. . Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts male aging study. J Clin Endocrinol Metab 1991 73, 1016–1025.

    Article  CAS  Google Scholar 

  4. Noldus A, Huland H. . Erectile dysfunction and hypogonadism is routine endocrine screening necessary? Urologie 1994 33, 73–76.

    CAS  Google Scholar 

  5. Carani C et al.Effect of androgen treatment in impotent men with normal and low levels of free testosterone. Arch Sex Behav 1990 19, 223–225.

    Article  CAS  Google Scholar 

  6. Burris AS et al.A long-term, prospective study of hormone replacement in untreated hypogonadal men. J Androl 1992 13, 297–302.

    CAS  PubMed  Google Scholar 

  7. National Institutes of Health Consensus Conferences. . Impotence. National Institutes of Health Consensus Development Panel on Impotence. JAMA 1993 270, 83–84.

    Article  Google Scholar 

  8. Davidson JM, Camargo CA, Smith ER. . Effects of androgen on sexual behaviour in hypogonadal men. J Clin Endocrinol Metab 1979 48, 955–958.

    Article  CAS  Google Scholar 

  9. O'Carrol R, Bancroft J. . Testosterone therapy for low sexual interest and erectile dysfunction in men: a controlled study. Br J Psychiatry 1984 145, 146–151.

    Article  Google Scholar 

  10. The American Urological Association (AUA). . Guidelines for Treating Erectile Dysfunction Issued. JAMA 1997 277, 7–8.

    Article  Google Scholar 

  11. Gomaa A et al.Topical treatment of erectical dysfunction: randomised double blind placebo controlled trial of cream containing aminophylline, isosorbide dinitrate, and co-dergocrine mesylate. Br Med J 1996 312, 1512–1515.

    Article  CAS  Google Scholar 

  12. Kao J, Hall J. . Skin resorption and cutaneous first pass metabolism of topical steroids: in vitro studies with mouse skin in organ culture. J Pharmacol Exp Ther 1979 241, 482–487.

    Google Scholar 

  13. Carani C, Granata AR, Fustini MF, Marrama P. . Prolactin and testosterone: their role in male in male sexual function. Int J Androl 1996 19, 48–54.

    Article  CAS  Google Scholar 

  14. Morales A, Johnston B, Heaton JPW, Lundie M. . Testosterone supplementation for hypogoonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol 1997 157, 849–854.

    Article  CAS  Google Scholar 

  15. Bond A, Bader M. . The use of analogue scales in rating subjective feelings. Br J Med Psychol 1974 47, 211–218.

    Article  Google Scholar 

  16. Slob AK, Blom JHM, Bosch JJW. . Erection problems in medical practice: differential diagnosis with relatively simple method. J Urol 1990 143, 46–50.

    Article  CAS  Google Scholar 

  17. Guay AT, Bansal S, Heatley GJ. . Effect of raising endogenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate. J Clin Endocrinol Metab 1995 80, 3546–3552.

    CAS  PubMed  Google Scholar 

  18. Skakkebach NE, Bancroft J, Davidson DW. . Androgen replacement with oral testosterone undecanoate in hypogonadal men: a double blind controlled study. Clin Endocrinol 1981 4, 49–55.

    Article  Google Scholar 

  19. Davidson JM, Camargo GA, Smith ER. . Effect of androgen on sexual behavior in hypogonadal men. J Clin Endocr Metab 1979 5, 95–99.

    Google Scholar 

  20. Aydin S et al.Efficacy of testosterone, trazodone and hypnotic suggestion in the treatment of nonorganic male sexual dysfunction. Br J Urol 1996 77, 256–260.

    Article  CAS  Google Scholar 

  21. Kwan M et al.The nature of androgen action on male sexuality: a combined laboratory self-report study on hypogonadal men. J Clin Endocr Metab 1983 57, 557–560.

    Article  CAS  Google Scholar 

  22. Clopper RR et al.Psychosexual behavior in hypopituitary men: a controlled comparison of gonadotropin and testosterone replacement. Psychoneuroendocrinology 1993 18, 149–152.

    Article  CAS  Google Scholar 

  23. Arver S et al.Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996 155, 1604–1608.

    Article  CAS  Google Scholar 

  24. Rajfer J. . Andrology. J Urol 1994 152, 891–901.

    Article  CAS  Google Scholar 

  25. Brock G, Lue TF. . Impotence: a patient's goal-directed approach. Monogr Urol 1992 143, 586–588.

    Google Scholar 

  26. Negeleve S. . Topical nitroglycerin: a potential treatment for impotence. J Urol 1990 143, 586–588.

    Article  Google Scholar 

  27. Calabro A et al.New topical formulation of isosorbide dinitrate in the treatment of male impotence. Pharm Sci 1995 1, 499–500.

    CAS  Google Scholar 

  28. Buch PA, Aronson WJ, Buga GM, Ignarro IJ. . Nitric oxide is a potent relaxant of human and rabbit corpus cavernosum. J Urol 1992 147, 1650–1655.

    Article  Google Scholar 

  29. Buvat J, Buvat-Herbour M, Lemaire A, Marcolin G. . Applications diagnostiques et therapeutiques des injections intracaverneuses (i.c) de drognes vasoactive dans l'impuissance. Ploidoyer pour l'utilisation de drogues facilitatrices. II. Applications diaggnostiques et therpeutiques. J Urol (Paris) 1989 95, 89–92.

    CAS  Google Scholar 

  30. Gomaa AA et al.Treatment of impotence by Eroderm cream. Eur J Pharmacol 1994 49, A 101.

    Google Scholar 

  31. Meuleman EJH et al.Assessment of penile blood flow by duplex ultrasonography in 44 men with normal erectile potency in different phases of erection. J Urol 1992 147, 51–56.

    Article  CAS  Google Scholar 

  32. Knoll LD et al.A randomized crossover study using yohimbine and isoxsurpine versus pentoxifylline in the management of vasculogenic impotence. J Urol 1996 155, 144–146.

    Article  CAS  Google Scholar 

  33. Reilly CM, Zamorano P, Stopper VS, Mills TM. . Androgenic regulation of NO availability in rat penile erection. J Androl 1997 18, 110–115.

    CAS  PubMed  Google Scholar 

  34. Penson DF et al.Androgen and pituitary control of penile nitric oxide synthase and erectile function in the rat. Biol Reprod 1996 55, 567–571.

    Article  CAS  Google Scholar 

  35. Shabseigh R. . The effect of testosterone on the cavernous tissue and erectile function. World J Urol 1997 15, 21–26.

    Article  Google Scholar 

  36. Reilly CM, Stopper VS, Mills TM. . Androgens modulate the alpha-adrenergic responsiveness of vascular smooth muscle in the corpus cavernosum. J Androl 1997 18, 2631–2635.

    Google Scholar 

  37. Kaya T et al.Effect of additional testosterone on purinergic responses in isolated rabbit corpus cavernosum strips. Pharm Res 1998 37, 227–232.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Faculty of Medicine, Assiut University, Assiut, Egypt

    A Gomaa, M Eissa & A El-Gebaley

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  1. A Gomaa
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  2. M Eissa
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  3. A El-Gebaley
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Correspondence to A Gomaa.

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Gomaa, A., Eissa, M. & El-Gebaley, A. The effect of topically applied vasoactive agents and testosterone versus testosterone in the treatment of erectile dysfunction in aged men with low sexual interest. Int J Impot Res 13, 93–98 (2001). https://doi.org/10.1038/sj.ijir.3900643

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