Research · PMID 29150464 · Landmark study
Reviewed by Neal Rouzier, MD, Preventive Medicine · Sep 2026
Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis.
BMJ open · November 2017 · Jesse Elliott, Shannon E Kelly, Adam C Millar, Joan Peterson, Li Chen, et al.
What this study found
Despite 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 asses…
Why this trial matters
TRT sexual function review
How RAGMD uses this study
Clinical questions this paper informs
Synthesis lives on the evidence question — this page shows where the study sits in that analysis.
Supporting literature
Does testosterone therapy improve depression or low mood in hypogonadal men?
Some randomized trials and meta-analyses show modest improvements in depressive symptoms among men with low testosterone, but effects are heterogeneous and not a substitute for standard psychiatric evaluation when major depression is present.
Open evidence analysisSupporting literature
Does testosterone therapy improve erectile function in hypogonadal men?
Testosterone improves sexual desire and some erectile function endpoints in men with confirmed hypogonadism, but effects are smaller than PDE5 inhibitors for vascular erectile dysfunction. Treat documented deficiency when indicated; do not rely on testosterone alone for moderate-to-severe ED without evaluating PDE5 therapy.
Open evidence analysis