DHT Gel Shuts Down LH, FSH, Estradiol and T But Sustained Sexual Function

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Nelson Vergel

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Sartorius GA, Ly LP, Handelsman DJ.

Male Sexual Function Can Be Maintained Without Aromatization: Randomized Placebo-Controlled Trial of Dihydrotestosterone (DHT) in Healthy, Older Men for 24 Months. The Journal of Sexual Medicine.

http://onlinelibrary.wiley.com/doi/10.1111/jsm.12550/abstract

Introduction Male sexual function is highly androgen dependent but whether aromatization of testosterone (T) to estradiol is required remains contentious.

Aim This study aims to investigate the effects of selective estrogen deficiency induced by a nonaromatizable androgen, dihydrotestosterone (DHT), on sexual function of healthy middle-aged and older men.

Methods
Randomized clinical trial of daily transdermal DHT (70 mg) or placebo gel treatment in 114 healthy middle-aged and older (>50 years, mean 60.5 years) men without known prostate disease maintaining selective estrogen deficiency for 24 months.

Outcome Measures and Analysis
The end points were responses to a psychosexual and mood questionnaire completed before, at 3 months, then at 6 monthly intervals during and 3 months after study. Data were analyzed by mixed model analysis of variance for repeated measures using age and body mass index (BMI) as covariates and including interactions of treatment with age and time-on-study.

Results
DHT treatment increased serum DHT with complete suppression of serum T, luteinizing hormone, follicle stimulating hormone, and estradiol throughout the 24-month study resulting in reduced spinal bone density.

There were no spontaneous complaints, or discontinuations for, adverse effects on sexual function during the study.

DHT administration had no effects on any of 33 measures of sexual function and mood, apart from a mild, but significant decrease in overall sexual desire, which was reversible after cessation of treatment. Increasing age and less often increasing BMI were associated with significant decreases in most aspects of sexual function.

Conclusions We conclude that aromatization plays only a minimal role in maintenance of sexual function in healthy eugonadal middle-aged or older men, but age and obesity are significantly associated with decreases in most aspects of self-reported sexual function and satisfaction.

The dependence of male sexual function on aromatization may be conditional on age and obesity and can be overcome by a nonaromatizable androgen.
 
Defy Medical TRT clinic doctor
This surprised me: DHT administration had no effects on any of 33 measures of sexual function and mood, apart from a mild, but significant decrease in overall sexual desire, which was reversible after cessation of treatment.

Many men claim to have a significant increase in libido and sex drive when DHT is increased.
 
Actually, no change in sexual parameters while using DHT alone is not a bad thing. It means that sex drive was able to be sustained even with no testosterone and estradiol in the blood. This effect was not as evident in heavier and older men (these men were above 50 years of age).

I guess these findings would be different if you used DHT gel plus TRT. In this study it was used alone so it shut down T, LH, FSH and estradiol. I bet DHT+ TRT would really increase sex drive but also potential DHT related side effects like scalp hair loss, body hair growth, oily skin/acne.
 
I think this study is significant in that it showed DHT administration DECREASED libido.This underscores what I've written many times about so-called "finesteride syndrome",that is it isn't as related to Lowered DHT as much as Beleived.Thousands of men have used finesteride with no significant effects on sexual function.Those that do experience this problem have something else going on,IMHO.
 
From the paper (which is attached to this post). I do not agree with a few of these observations.


"Administration of nonaromatizable androgens such as DHT, nandrolone, or mesterolone may improve or at least not impair male sexual function. For example, in studies of sexual function, oral DHT undecanoate treatment of agonadal men maintains sexual function for 9 weeks [31], whereas sexual function was also improved more than placebo with daily DHT gel administration for 6 months to men with andropause symptoms and serum T<15 nmol/L [32]. Among studies of at least 1 month duration where adverse effects on sexual function may have led to discontinuations, no spontaneous complaints were reported in placebo- controlled studies of 1 [33] or 3 [34] months duration, a crossover study of 1 month duration [35] as well as uncontrolled studies of 5 months [36] or 3 months [37] duration. Similar observations apply to nandrolone, another potent androgen that is minimally or not aromatized in vitro [38] or in vivo [39,40]. When administered to men with HIV and weight loss, nandrolone improved sexual function more than placebo [41], whereas other placebo- controlled studies of nandrolone administration of at least 1 month duration reported no spontaneous complaints of adverse effects on sexual function [42&#8211;44]. Similar effects are reported with a nandrolone analog, 7&#945; methyl nandrolone [45].

Furthermore, the widespread illicit abuse of nandrolone by bodybuilders is not accompanied by complaints of sexual dysfunction. Finally, administration of 100 mg mesterolone, an oral DHT analog, daily for 4 weeks improves sexual function of hypogonadal men [46]. In the latter double- blind study although mesterolone was less effective than 120 mg oral T undecanoate, mesterolone effects may have been underestimated in the absence of a known dose-response for mesterolone through possibly using a suboptimal dose.

Furthermore, the aromatization hypothesis that male sexual function is estrogen dependent pre- dicts that estrogen receptor blockade may be detrimental to male sexual function. However, estrogen receptor blockers such as clomiphene, tamoxifen, raloxifene, or other mixed estrogen receptor agonist/antagonists have long been used off-label to treat men complaining of andropause, gynecomastia, infertility, and androgen abuse- induced hypogonadism. Although there are no speci&#64257;c studies of male sexual function, the best available evidence suggests that antiestrogen treatment does not impair male sexual function [47&#8211;53]."
 

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