Steven Smoger, MD
Potential Conflicts of Interest: Employment: Veterans Affairs.
Smoger S.; Effects of Testosterone Replacement on Response to Sildenafil Citrate. Ann Intern Med. 2013;158:569. doi: 10.7326/0003-4819-158-7-201304020-00016
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Published: Ann Intern Med. 2013;158(7):569.
TO THE EDITOR:
In Spitzer and colleagues' article (1) about combining testosterone replacement and sildenafil, the authors do not comment on whether the variability of testosterone measurements could explain the ineffectiveness of testosterone replacement. From clinical experience, this seems to be a common occurrence and may influence the decision to consider hormone replacement. In addition, the baseline body mass index was greater than 31 kg/m2 in both groups, raising the question of whether levels of the sex hormone–binding protein could explain the lower average testosterone level.
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