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. 2020 Oct 1;11(5):1202–1218. doi: 10.14336/AD.2019.1028

Figure 1.

Figure 1.

Management of patients with ED and hypogonadism. In patients with ED, more attention should be paid to testosterone supplementation after hypogonadism is confirmed by the detection of testosterone. In patients with ED and hypogonadism, some will recover from ED after treatment with PDE5is, but others will show nonresponsiveness to PDE5is; in these cases, ED can be treated by adding testosterone to the PDE5i treatment. The reason for this lack of a response is that PDE5 is under the control of testosterone, and a normal testosterone level is the basis for the full effect of PDE5is. Therefore, in ED patients with hypogonadism, we recommend giving priority to testosterone supplementation to treat a portion of them and using a combination of testosterone supplementation and PDE5is for the remaining patients.