In older men the addition of testosterone replacement therapy can revolutionise the management of Erectile Dysfunction.

Testosterone replacement therapy has changed quite significantly in the last ten years. Ten years ago, before a man was considered suitable for TRT, he was required to undergo a battery of hormonal assays. These included exotic named tests like free and bonded testosterone, sex hormone binding globulin, serum prolactin and luteinizing hormone.

All that has now changed. These tests were not only very expensive they were also unhelpful. Blood levels of testosterone, free or bonded, are notoriously unreliable and difficult to interpret. Recently I have abandoned their use altogether and replaced them with a more pragmatic approach of measuring benefit, if any, before and after testosterone treatment begins. The easiest way to do this is by using a self-assessment questionnaire called the ADAM test.

The ADAM test is a very simple one page questionnaire that anyone can use to score their own symptoms (if any) of Testosterone Deficiency Syndrome. No needles, no blood, no expensive laboratories, no uncertainty and no delays. It is simplicity itself. Score symptoms before treatment commences and one month later. If there is no improvement then perhaps TRT is not for you.

Another recently introduced improvement in the management of androgen deficiency was the introduction of a sustained release intramuscular injection called Nebido. Administered by a doctor every ten weeks this preparation is a big improvement on previous gels, implants, patches and erratic injections. I usually recommend gel for the first month to see if the ADAM score improves and then move on to Nebido if the client is impressed.

Finally, here is a useful tip for you. If you suffer from erectile dysfunction that does not respond adequately to Viagra 100 mg then ask your doctor to consider placing you on a trial of TRT. Often the addition of this hormone allows Viagra, Cialis or Levitra to click in and allow you to enjoy intercourse as you have always done before.

Author's Bio: 


Dr. Andrew Rynne.

Dr. Andrew Rynne is a General Practitioner with a special interest in men’s health but most particularly men’s sexual health. He has over fifteen years experience in treating men with sexual dysfunction --- erectile dysfunction and or low sex drive in the older man. He is medical director of an Internet driven medical practise at He was the first doctor in Ireland to perform a vasectomy under local anaesthesia in 1974.

He is registered in the UK with the General Medical Council and in Ireland with the Irish Medical Council. He is a Member of the Irish College of General Practise and a 1968 graduate of The Royal College of Surgeons in Dublin. He spent the first seven years of his professional life in Ontario Canada where he ran a very busy general practise and was appointed County Coroner for Perth County Ontario.

In 1983 Rynne was fined £500.00. for selling a packet of condoms contrary to the provisions of the then Irish Family Planning Act. This was a deliberate act of civil disobedience designed to highlight the ludicrous laws that then governed the sale and distribution of contraception in Ireland. Following this case the laws were immediately liberated.

In 1985 Dr. Rynne founded Clane General Hospital in Co. Kildare. Today Clane Hospital is a thriving health care in-patient facility catering for all the major medical and surgical disciplines and specialising in In-Vitro Fertilisation under the guidance of The Bornhall Clinic in London, the birth place of IVF treatments. Dr. Rynne is a Board Member of Clane General Hospital which now employs over 200 people.

Author of three books --- Smoking Is Your Decision, Abortion -- The Irish Question and more recently a memoir The Vasectomy Doctor, Rynne was the subject of a RTE documentary in 2006 based on this memoir.

Contact Dr Rynne at:
Office: 00 353 45 893885.
Home: 00 353 45 860114.
Mobile: 00 353 87 2559024.
Address: The Woods Surgery,
Co. Kildare. IRELAND.