Type 2 Diabetic (T2D) men are three times more likely to suffer from erectile dysfunction than men without diabetes. Erectile dysfunction is often seen associated with low testosterone (Hypogonadism). Hypogonadism is defined as having low testosterone levels along with sexual symptoms. As a physician who treats erectile dysfunction (ED), I have seen more and more diabetics come in for this exact issue.

It’s known that Testosterone replacement (TRT) can significantly improve sexual function in men without diabetes. Diabetic men had previously shown some improvements in sexual desire, but poor improvement in erectile function. A recent study in the Journal Andrology looked at the effect of TRT on sexual desire and erectile function in men with mild and severe hypogonadism. It also looked at duration of treatment and benefits of TRT at 6, 18, and 30 weeks for comparison.

Results showed that in T2D men with mild hypogonadism, 36-39.6% had improvement in sexual desire at 6-30 weeks. Improvement in sexual function was also 40-39.6% at 6-30 weeks. The interesting thing was that T2D men with the lowest initial testosterone levels showed the greatest response to TRT. Improvement in sexual desire increased to 60% at 6 weeks and 74% at 30 weeks. Erectile function improved to 36.7% at 6 weeks and increased to 63% at 30 weeks.

This study showed that improvements in erectile function may take longer than we previously considered. Prior to this I used to tell my patients that based on my clinical experience, erectile function could take up to 6 months to improve. Now I know that it’s closer to 8 months of therapy before TRT can demonstrate a benefit at the tissue level for most patients. Improvements in erectile function takes longer because the changes that testosterone must provide have to occur at the tissue level. This is essential information to know in that most men may become frustrated and quit therapy before TRT has a chance to improve erectile function. The more we know, the better we can treat our patients.