Combination therapy with testosterone and vardenafil is safe and effective in treating hypogonadal men with erectile dysfunction (ED) and who failed to respond to testosterone monotherapy, according to researchers.

In a prospective study, 129 testosterone deficient men (serum total testosterone 3.4 ng/mL or less) received intramuscular injections of long-acting parenteral testosterone undecanoate at three-month intervals. The mean follow-up was eight months. Of the 129 men, 71 (58.2%) responded well to monotherapy within three months.

According to the investigators, non-responders had lower testosterone levels and higher rates of concomitant diseases and smoking. Among the non-responders, 34 accepted the addition of 20 mg vardenafil on demand. Thirty of 34 patients responded well to this combination, Dany-Jan Yassin, MBBS, of Klinikum Braunschweig, Braunschweig, Germany, and colleagues reported online ahead of print in the Journal of Sexual Medicine. The score on the International Index of Erectile Function-Erectile Function domain improved significantly from 12 to 24, and partner survey showed significantly higher satisfaction. “These patients reported spontaneous or nocturnal and morning erections or tumescence,” the researchers noted.