Hormonal therapy for erection problems

Examples

These medications are given as an injection every 2 to 3 weeks.

Androderm and Testoderm contain testosterone in a patch that is placed on the skin. AndroGel is a gel that is applied in specific amounts to the arms, legs, shoulders, or upper abdomen. The medication is then absorbed through the skin.

These medications can be used to treat men who have high prolactin levels, which can reduce the amount of testosterone produced by the body and may lead to problems such as infertility or erection problems. Bromocriptine and cabergoline are taken by mouth.

How It Works

Replacing testosterone, if it is low, may increase a man's sexual desire, or libido.

Bromocriptine and cabergoline help to lower the amount of prolactin in the body. In some men, a noncancerous tumor on the pituitary gland causes the gland to produce too much prolactin.

Why It Is Used

Testosterone may be prescribed for men who have low testosterone levels. It is not recommended for men with testosterone levels in the low part of the normal range.

Bromocriptine and cabergoline may be prescribed for men with high prolactin levels.

Blood tests are needed to determine the levels of these hormones.

How Well It Works

Testosterone may improve libido and, as a result, may improve erection problems (erectile dysfunction) in men who have low testosterone levels.¹

Bromocriptine and cabergoline may help restore sexual interest and potency when erection problems are caused by high prolactin levels. At least 4 weeks of continuous therapy is needed to lower the prolactin level to the normal range.¹

Side Effects

Side effects of testosterone may include:

• An elevated number of red blood cells (polycythemia), which can increase the risk of stroke or heart attack.
• Painful enlargement of the breasts.
• Water retention.
• High blood pressure.
• An elevated blood cholesterol level.
• Abnormal liver function tests.
• Increased risk of heart failure.
• Increased prostate-specific antigen (PSA) levels.
• Increased growth of preexisting prostate cancer.

Side effects of bromocriptine may include:

• Confusion, hallucinations, and uncontrolled body movements, particularly in older men.
• Worsening of liver disorders.
• Worsening of certain mental disorders.
• High blood pressure.
• Infertility.

Side effects of cabergoline may include:

• Low blood pressure.
• Headache, dizziness, and vertigo.
• Depression, nervousness, and anxiety.
• Abdominal pain, nausea, constipation, diarrhea, and flatulence.
• Dry mouth.
• Anorexia and weight fluctuation.

Side effects may cause some men to stop taking the medication. Nervous system and mental side effects may linger for 2 to 6 weeks after a man stops taking the medication.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

When considering hormonal therapy for erection problems, it is important to include your partner in your decision.

During the first year of testosterone therapy, you should receive a prostate examination, a PSA blood test, a complete blood count, and a liver function test every 3 to 6 months.

Although replacement of testosterone through injections or patches can improve a man's libido, it does not always improve a man's ability to have an erection.

Cabergoline given weekly is as effective as daily doses of bromocriptine and may be associated with fewer side effects.² Prolactin levels should be monitored monthly.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

Citations

1. Lue TF (2004). Male sexual dysfunction. In EA Tanagho, JW McAninch, eds., Smith's General Urology, 16th ed., pp. 592–611. New York: McGraw-Hill.

2. Molitch ME (2004). Hyperprolactinemia. In RE Rakel, ET Bope, eds., Conn's Current Therapy, pp. 685–689. Philadelphia: Saunders.

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