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

The objective was to evaluate the efficacy and safety of topically applied cream containing testosterone, isosorbide dinitrate and co-dergocrine mesyl ate 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 random ly allocated to two equal groups. Polypharmacy cream containing testosteron e 0.8%, isosorbide dinitrate 0.5% and co-dergocrine mesylate 0.06% was appl ied 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 tr eatment. Response to each therapy was assessed by a sexual questionnaire, m easurement of tumescence and repeat penile duplex ultrasonography, Twenty-e ight patients reported full erection and satisfactory intercourse with the polypharmacy cream. Thirteen men reported full erection and satisfactory in tercourse with either cream. Polypharmacy cream increased penile arterial d ow (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 caver nous arterial peak systolic velocities after the application of testosteron e 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 trea tment with polypharmacy cream and testosterone cream, respectively, No mark ed side effects were reported after either of them. Topical treatment with cream containing testosterone and vasoactive agents may represent a new eff ective treatment for erectile dysfunction associating with aging.