N, osteoporosis, reduced lean body mass, depressed mood and fatigue. Men with low testosterone may find Viagra ineffective. The large number of men who suffer from this dysfunction has caused tremendous demand for drugs like Viagra (sildenafil) to help improve sexual interest and performance. This new study promises even better results with the addition of the gel. Dr. Ridwan Shabsigh, associate professor of urology at Columbia University College of Physicians & Surgeons and director of the New York Center for Human Sexuality at NewYork-Presbyterian Hospital Columbia was the lead investigator in the study, which is published in the August issue of the Journal of Urology. "Our data support the potential benefits of a combination therapy with testosterone gel for men with erectile dysfunction and low testosterone who find sildenafil by itself ineffective," said Dr. Shabsigh. "When assessing erectile dysfunction, doctors and patients should consider using a simple blood test to determine if low testosterone is a contributing factor. If the root cause is low testosterone, sildenafil alone won't fix the problem." Sildenafil enhances the effects of nitric oxide, a chemical in the body that allows increased blood flow to the penis during sexual stimulation. "Research suggests nitric oxide may be dependent on testosterone to function properly," said Dr. Shabsigh. "While further studies are needed, this concept may explain why testosterone replacement therapy could help hypogonadal men who do not respond to sildenafil." In the trial, 75 hy
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