The intracavernous injection technique exploded across America after that. While the development of the penile prosthesis technology was the breakthrough treatment of the 1970s for treating erectile dysfunction, the exciting contribution of the early 1980s was when the French researcher Virag first reported his finding of erections induced by injecting papaverine into the penis. In those patients with a severely depressed serum testosterone level, consultation with an endocrinologist is advised before initiating any hormone replacement therapy with any of the testosterone preparations. Although all of us who treat patients with erectile dysfunction have a number of patients in our practice who swear by the positive effects of their monthly Depo-Testosterone injection, control studies have revealed less than a 10 percent improvement rate for men with erectile dysfunction.

In addition, oral testosterone preparations definitely increase the risk of liver problems, requiring close monitoring of liver function in those few individuals who are best managed with the oral methyltestosterone preparations. All males over the age of 50 should have an annual digital rectal examination along with a blood PSA level, as a minimum. All males over the age of 50 who are treated with extra testosterone, whether by injections or skin patches, should be aware of the potential side effects, including aggravation of any occult (present, but causing symptoms) cancer of the prostate. While hormone replacement therapy is easy to administer, reasonably safe, and reasonably inexpensive, it is not without increased risks and side effects. The extra testosterone may also be converted to estradiol, an estrogen substance, that potentially may be detrimental to sexual function. When patients take androgen replacement therapy, the outside source of testosterone can suppress production of testosterone by the testicles, leading to testicular atrophy. It is recommended that a 1 men over the age of 50 receiving androgen, testosterone, initially have a prostate specific antigen level measurement along with a digital rectal exam.

It is relatively contraindicated in older men with bladder neck obstruction from prostate enlargement. Therefore, while it's important for such patients to maintain reasonably normal levels of blood testosterone for other clinical reasons, such as bone metabolism, they are less likely to see a profound response in their erectile function. The majority of older men usually suffer from a combination of neurovascular problems that outweigh the singular effects of testosterone deficiency on erectile dysfunction. In some young males with insufficient testosterone, hormone replacement has a greater chance of resulting in a modest improvement in erectile function. A recent clinical study involving men with low testosterone levels, reported only a 9 percent response rate for patients treated with oral androgen replacement.