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Permitting that there is no pre-existing diagnosis of penile impairment before anabolic steroid use, it is reasonable to expect the erectile dysfunction to ceasefor the first few weeks of steroid treatment (see figure 7.2-27). But this expectation is too simplistic and inadvisable to implement. Although testosterone does not normally affect the production of erectile dysfunction for more than 6 months if given on an alternate regimen and maintained at an adequate level, a new study was completed before the 2003 IAAF World Championships.13 The team from the International Association for the Study of Steroidogenesis (IASS) included 15 men who had never been in the clinical laboratory for hormone use. They were administered testosterone as well as testosterone and estradiol to determine to some degree whether the testes would receive a testosterone-induced response. The results of the study were that the testes received a testosterone response only after 6 months. If we were to attempt to make generalizations about a testosterone-induced response to the use of any drug administered once a week without medical supervision, it then means that the testosterone response could be achieved much longer than 6 months. In that case, there would be little reason for any additional testing, let alone testosterone or estrogen replacement. Figure 7.2—Effect of a long testosterone-replete regimen on erectile dysfunction When to prescribe In general, in order to be successful in treating erectile dysfunction, it would be helpful to start as soon as possible after you discover you have an erectile dysfunction. A man would need to have some sort of diagnosis, preferably one that is specific to your condition; however, there are a great many possible diagnoses and a few are not even relevant to the issue. If you do not have a clear diagnosis, consult your physician when you first notice symptoms such as decreased sexual desire. In that case, the goal of treatment would be to find a drug that would restore sexual motivation without harming your ability to perform physically. The first testosterone to be used by anyone should be taken on an alternate schedule to that used by most who start use. Although the duration of the daily "prescription" has been determined, it should be used every day, preferably in the morning. If you have concerns that the dose could cause increased sexual desire or decreased ability to perform physically after taking the steroids, talk to your physician about starting you on an alternate schedule. If sexual desire or energy is present as a result of having a testosterone-injected erection, or you are not able to have an erection or are worried that you might be losing the ability to have one, then you would need to discontinue taking the Related Article:

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