SynthesisBMJ open2017
Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis.
Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
54 citing papers in PubMed, 6 syntheses or guidelines pooled it, 142 citations in OpenAlex.
- Hyperprolactinemia and male sexual function: focus on erectile dysfunction and sexual desire.International journal of impotence research · 2024Pooled it
- Testosterone replacement in men with sexual dysfunction.The Cochrane database of systematic reviews · 2024Pooled it
- Adult- and late-onset male hypogonadism: the clinical practice guidelines of the Italian Society of Andrology and Sexual Medicine (SIAMS) and the Italian Society of Endocrinology (SIE).Journal of endocrinological investigation · 2022Guideline
- Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis.The lancet. Healthy longevity · 2022Pooled it
- Systematic review of sex differences in the relationship between hormones and depression in HIV.Psychoneuroendocrinology · 2022Pooled it
- Association of Testosterone Treatment With Alleviation of Depressive Symptoms in Men: A Systematic Review and Meta-analysis.JAMA psychiatry · 2019Pooled it
- Effects of testosterone enanthate on aggression, risk-taking, competition, mood, and other cognitive domains during 28 days of severe energy deprivation.Psychopharmacology · 2024Trial
- Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism: A Randomized Clinical Trial.JAMA network open · 2023Trial
- Effect of exogenous testosterone on cardiovascular, cerebrovascular, and thromboembolic adverse events: results of three complementary research designs.American journal of epidemiology · 2026Article
- Real-World Outcomes and Safety of Testosterone Therapy: A Longitudinal, Retrospective Cohort Study of Over 9,000 Men.The world journal of men's health · 2026Article
- Endogenous Testosterone, Testosterone Treatment, and Cardiovascular Health Outcomes in Men.The Journal of clinical endocrinology and metabolism · 2026Review
- Confidence in Managing Use and Minimising Harm as Mediators of Quality of Life among Anabolic-Androgenic Steroid Consumers in Alcohol and Other Drug Treatment Settings.European addiction research · 2026Article
- Review
- Bigger than sport: the enhanced games and the commodification of telehealth, testosterone, and dependency.Harm reduction journal · 2025Article
- Male Hypogonadism: The Korean Society of Men's Health and Aging Position Statement.The world journal of men's health · 2025Review
- Association between Low Serum Testosterone Levels and All-cause Mortality in Patients With Cardiovascular Disease: A Study Based on the NHANES Database.Cardiovascular toxicology · 2025Article
- Clomiphene Citrate Treatment as an Alternative Therapeutic Approach for Male Hypogonadism: Mechanisms and Clinical Implications.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Exploring the relationship between earthquake exposure and severity of erectile dysfunction in southern part of Türkiye.Investigative and clinical urology · 2024Article
- Impact of Testosterone Therapy on Major Cardiovascular Risk in Erectile Dysfunction Patients with Testosterone Deficiency.Research and reports in urology · 2024Article
- Psychoneuroendocrine profiles of unmedicated men with major depressive disorder and associations to treatment effects and sexual side-effects.Neuroscience applied · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the relative effects of individual testosterone products among hypogonadal men.
designSystematic review and network meta-analysis.
methodsWe searched MEDLINE, Embase, Cochrane CENTRAL, and grey literature (25 May 2017) for randomised-controlled trials (RCTs) and non-randomised studies (NRS) that involved hypogonadal men given testosterone replacement therapy (TRT) for ≥3 months. Comparators were placebo, another TRT, or the same product at a different dose. Outcomes were quality of life, depression, libido, erectile function, activities of daily living and testosterone levels, as well as cardiovascular death, myocardial infarction, stroke, prostate cancer, heart disease, diabetes, serious adverse events, withdrawals due to adverse events and erythrocytosis. RCT data were pooled via meta-analysis and network meta-analysis. Risk of bias was assessed using Cochrane's risk of bias tool (RCTs) andScottish Intercollegiate Guidelines Network (SIGN)50 (NRS).
resultsEighty-seven RCTs and 51 NRS were included. Most were at high or unclear risk of bias, with short treatment duration and follow-up. When compared as a class against placebo, TRT improved quality of life (standardised mean difference (SMD) -0.26, 95% CI -0.41 to -0.11), libido (SMD 0.33, 95% CI 0.16 to 0.50), depression (SMD -0.23, 95% CI -0.44 to -0.01) and erectile function (SMD 0.25, 95% CI 0.10 to 0.41). Most individual TRTs were significantly better than placebo at improving libido (6/10). Only one TRT was better than placebo at improving quality of life, and no individual TRTs improved depression or erectile function. There was no increased risk of adverse events, with the exception of withdrawals due to adverse events with the use of some TRTs.
conclusionDespite a class effect of improving quality of life, depression, erectile function and libido, major improvements were not observed with the use of any individual product. We observed no statistically significant increase in the risk of adverse events; however, longer-term high-quality trials are needed to fully assess the risk of harm. PROSPERO REGISTRATION NUMBER: CRD42014009963.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.