The objective was to evaluate the efficacy and safety of topically applied cream containing
testosterone,
isosorbide dinitrate and
co-dergocrine mesylate compared to
testosterone cream in the treatment of
erectile dysfunction in aged men with low sexual interest. A randomised double-blind crossover trial was performed over two months. The subjects were 42 men with
erectile dysfunction and low normal or slightly depressed
testosterone level randomly allocated to two equal groups.
Polypharmacy cream containing
testosterone 0.8%,
isosorbide dinitrate 0.5% and
co-dergocrine mesylate 0.06% was applied for one month, and
testosterone 0.8% cream for another month. The serum level of total
testosterone was measured before and after each phase of treatment. Response to each
therapy was assessed by a sexual questionnaire, measurement of tumescence and repeat penile duplex ultrasonography. Twenty-eight patients reported full erection and satisfactory intercourse with the
polypharmacy cream. Thirteen men reported full erection and satisfactory intercourse with either cream.
Polypharmacy cream increased penile arterial flow (P<0.001) and induced tumescence in 34 patients in lab. No patient in either phase of the study has tumescence or a significant increase in cavernous arterial peak systolic velocities after the application of
testosterone cream. Serum level of total
testosterone increased in all patients (P<0.05). Sexual desire was improved in 85% and 62% of patients during the treatment with
polypharmacy cream and
testosterone cream, respectively. No marked side effects were reported after either of them. Topical treatment with cream containing
testosterone and vasoactive agents may represent a new effective treatment for
erectile dysfunction associating with aging.