Seidman Stuart N, Roose Steven P
Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA.
J Sex Marital Ther. 2006 May-Jun;32(3):267-73. doi: 10.1080/00926230600575355.
Symptoms of male hypogonadism such as low libido and erectile dysfunction (ED) respond to testosterone (T) replacement. In hypogonadal men with major depressive disorder (MDD), the extent to which T replacement alleviates sexual symptoms of hypogonadism is not known. We conducted 6 week double-blind placebo-controlled clinical trial in men with low and low-normal T levels (i.e., total T <or= 350 ng/dl) and MDD. Men were randomized to receive weekly intramuscular injections of either T enanthate 200 mg or sesame-seed oil (placebo). The primary outcome measure was self-reported sexual functioning. We randomized 30 patients. The mean age was 52(SD +/- 8) years, mean T level 262.5(SD +/- 8) ng/dl, and mean baseline Hamilton Rating Scale for Depression (HAM-D) score 21(SD +/- 8). At baseline, sexual function was low, with the majority reporting having had normal erectile and orgasmic functioning 0-1 time in the preceding month. All patients who received T achieved normalization of their T levels. The HAM-D scores decreased significantly in both T and placebo groups, and there were no significant between-group differences: reduction in mean HAM-D score from baseline to endpoint was 10.1 in patients who received T and 10.5 in those who received placebo. Self-reported sexual functioning improved slightly in both groups; a between-group difference was not detected. Both T replacement and placebo were associated with improvement in sexual function and mood, but differences between T and placebo were not distinguishable.
男性性腺功能减退的症状，如性欲低下和勃起功能障碍（ED），对睾酮（T）替代治疗有反应。在患有重度抑郁症（MDD）的性腺功能减退男性中，T替代治疗缓解性腺功能减退性症状的程度尚不清楚。我们对睾酮水平低及低正常水平（即总睾酮≤350 ng/dl）且患有MDD的男性进行了为期6周的双盲安慰剂对照临床试验。男性被随机分为两组，分别每周接受一次200 mg庚酸睾酮或芝麻油（安慰剂）的肌肉注射。主要结局指标是自我报告的性功能。我们随机分配了30名患者。平均年龄为52（标准差±8）岁，平均睾酮水平为262.5（标准差±8）ng/dl，平均基线汉密尔顿抑郁量表（HAM-D）评分为21（标准差±8）。基线时，性功能较低，大多数人报告在前一个月勃起和性高潮功能正常的次数为0 - 1次。所有接受睾酮治疗的患者睾酮水平均恢复正常。睾酮组和安慰剂组的HAM-D评分均显著下降，且组间无显著差异：接受睾酮治疗的患者从基线到终点的平均HAM-D评分降低了10.1，接受安慰剂治疗的患者降低了10.5。两组自我报告的性功能均略有改善；未检测到组间差异。睾酮替代治疗和安慰剂均与性功能和情绪改善有关，但睾酮和安慰剂之间的差异无法区分。
