The effects of exogenous testosterone on sexuality and mood of normal men

Abstract

The effects of supraphysiological levels of testosterone, used for male contraception, on sexual behavior and mood were studied in a single-blind, placebo-controlled manner in a group of 31 normal men. After 4 weeks of baseline observations, the men were randomized into two groups: one group received 200 mg testosterone enanthate (TE) weekly by im injection for 8 weeks (Testosterone Only group), the other received placebo injections once weekly for the first 4 weeks followed by TE 200 mg weekly for the following 4 weeks (Placebo/Testosterone group). The testosterone administration increased trough plasma testosterone levels by 80%, compatible with peak testosterone levels 400-500% above baseline. Various aspects of sexuality were assessed using sexuality experience scales (SES) questionnaires at the end of each 4-week period while sexual activity and mood states were recorded by daily dairies and self-rating scales. In both groups there was a significant increase in scores in the Psychosexual Stimulation Scale of the SES (i.e. SES 2) following testosterone administration, but not with placebo. There were no changes in SES 3, which measures aspects of sexual interaction with the partner. In both groups there were no changes in frequency of sexual intercourse, masturbation, or penile erection on waking nor in any of the moods reported. The Placebo/Testosterone group showed an increase in self-reported interest in sex during testosterone treatment but not with placebo. The SES 2 results suggest that sexual awareness and arousability can be increased by supraphysiological levels of testosterone. However, these changes are not reflected in modifications of overt sexual behavior, which in eugonadal men may be more determined by sexual relationship factors. This contrasts with hypogonadal men, in whom testosterone replacement clearly stimulates sexual behavior. There was no evidence to suggest an alteration in any of the mood states studied, in particular those associated with increased aggression. We conclude that supraphysiological levels of testosterone maintained for up to 2 months can promote some aspects of sexual arousability without stimulating sexual activity in eugonadal men within stable heterosexual relationships. Raising testosterone does not increase self-reported ratings of aggressive feelings.

PIP: Testosterone is necessary, though not sufficient for normal levels of sexual desire. Researchers are currently investigating the potential role of supraphysiological doses of testosterone as an hormonal contraceptive for men. This paper reports findings from such a study of the effects of supraphysiological levels of testosterone upon sex behavior and mood in 31 men. A single-blind, placebo-controlled study design was employed. The men were aged 21-41 years, healthy, and in stable heterosexual relationships. All subjects were normal on clinical examination, and their plasma testosterone and gonadotropins were within the normal range. Baseline data were gathered on the subjects over a four-week period of observation. The men were then randomized into two groups, men in one group receiving 200 mg testosterone enanthate (TE) weekly by intramuscular injection for eight weeks, and men in the other group receiving placebo injections once weekly for the first four weeks followed by TE 200 mg weekly for the following four weeks. Testosterone administration increased trough plasma testosterone levels by 80%, compatible with peak testosterone levels 400-500% above baseline. Various aspects of sexuality were assessed using sexuality experience scales (SES) questionnaires at the end of each four-week period, while sexual activity and mood states were recorded in daily dairies and self-rating scales. There was a significant increase in both groups in scores in the Psychosexual Stimulation Scale of the SES (SES 2) following testosterone administration, but not following receipt of placebo. There were no changes in the measurement of sexual interaction with the partner and no changes in either group in the frequency of sexual intercourse, masturbation, or penile erection on waking nor in any of the moods reported. The placebo/testosterone group showed an increased self-reported interest in sex during testosterone treatment, but not with placebo. SES 2 results suggest that sexual awareness and arousability can be increased by supraphysiological levels of testosterone. These changes, however, are not reflected in any change in overt sexual behavior, which in eugonadal men may be more determined by sexual relationship factors; this contrasts with hypogonadal men in whom testosterone replacement clearly stimulates sexual behavior. No evidence was found to suggest an alteration in any of the mood states studied, in particular those associated with increased aggression. The authors conclude that supraphysiological levels of testosterone maintained for up to two months can promote some aspects of sexual arousability without stimulating sexual activity in eugonadal men within stable heterosexual relationships.