TRAVERSE Sexual Function Study: Libido Without Erectile Benefit

Last reviewed 2026-10-04 by Jack Mayeux, APRN, FNP. This page is clinical content and is reviewed on a regular schedule.

Medically reviewed by Jack Mayeux, FNP

Over 2 years, men with low T and low libido on testosterone reported more sexual activity and desire than placebo, and it held up.

This article walks through the J Clin Endocrinol Metab (2024) (https://doi.org/10.1210/clinem/dgad484) paper in plain English: what was studied, what changed, what the limits are, and what it does not prove. Full citation and DOI link (https://doi.org/10.1210/clinem/dgad484) are at the end, with a PubMed record (https://pubmed.ncbi.nlm.nih.gov/37589949/).

What the study found

Nested within the TRAVERSE trial, this study enrolled 1,161 men aged 45 to 80 with two testosterone levels below 300 ng/dL, low libido, and heart disease or elevated risk. They were randomized to testosterone gel (587) or placebo gel (574).

Testosterone improved sexual activity by about half an act per day vs placebo at 6 and 12 months, and the effect lasted to 24 months, with gains in desire and low-T symptoms. Erectile function did not improve compared with placebo.

Key finding (from the study record): Sexual activity up vs placebo by 0.49 acts/day at 6 mo and 0.47 at 12 mo (omnibus P=.011), maintained at 24 mo; improved desire and hypogonadal symptoms but NOT erectile function.

How the study was done

• Design: RCT substudy of TRAVERSE (Sexual Function Study) • Who was studied: 1,161 hypogonadal men 45-80 with low libido • Journal / year: J Clin Endocrinol Metab (2024) • First author: Pencina KM et al.

From the abstract: CONTEXT: Few long-term randomized trials have evaluated the efficacy of testosterone replacement therapy (TRT) in improving sexual function and hypogonadal symptoms in men with hypogonadism and whether effects are sustained beyond 12 months. OBJECTIVE: The Testosterone Replacement therapy for Assessment of long-term Vascular Events and efficacy ResponSE in hypogonadal men (TRAVERSE) study evaluated the effect of TRT on major adverse cardiovascular events in middle-aged and older men with hypogonadism. The Sexual Function Study, nested within the parent trial, determined testosterone's efficacy in improving sexual activity, hypogonadal symptoms, libido, and erectile function among men reporting low libido.

What it means — and what it does not

Useful takeaway: Over 2 years, men with low T and low libido on testosterone reported more sexual activity and desire than placebo, and it held up.

Limits and caveats: No effect on erectile function. Self-reported outcomes. Men 45-80 with low libido and CV risk only.

This evidence can inform a conversation with a licensed provider. It is not a guarantee of similar results for you, and it is not a recommendation to start, stop, or change any medication on your own.

Related research we cite

• Cardiovascular Safety of Testosterone-Replacement Therapy (https://doi.org/10.1056/NEJMoa2215025) — N Engl J Med (2023); also on PubMed (https://pubmed.ncbi.nlm.nih.gov/37326322/). Takeaway: In a 5,246-man randomized trial, men with low T on testosterone had no more heart attacks, strokes or cardiac deaths than men on placebo.

How this connects to care

A2Z serves men in Utah with telehealth evaluation, labs, and provider-guided plans when appropriate. The TRT program is $149/month and includes initial labs only. Tadalafil and enclomiphene, sermorelin, and tirzepatide (compounded, not FDA-approved) are separate products.

Relevant pages on this site:

• Tadalafil (https://a2ztrt.com/tadalafil) • TRT program (https://a2ztrt.com/trt)

FAQ

What did this study actually find?

Over 2 years, men with low T and low libido on testosterone reported more sexual activity and desire than placebo, and it held up. The design was: RCT substudy of TRAVERSE (Sexual Function Study). Population: 1,161 hypogonadal men 45-80 with low libido.

Does this mean I should start treatment?

No. Research informs care; it does not prescribe it. A licensed provider reviews your symptoms, labs, and history before any decision. Results vary.

What are the main limits of this evidence?

No effect on erectile function. Self-reported outcomes. Men 45-80 with low libido and CV risk only.

Keep reading

• TRAVERSE Anemia Substudy: TRT, Hemoglobin, and Energy in Men With Low T (https://a2ztrt.com/post/traverse-anemia-energy) • TRT and Insulin Sensitivity in Men With Type 2 Diabetes (https://a2ztrt.com/post/testosterone-insulin-sensitivity) • What Is a Normal Testosterone Level, Really? (https://a2ztrt.com/post/what-is-a-normal-testosterone-level) • Can You Drink Alcohol on TRT? What Men Should Know (https://a2ztrt.com/post/can-you-drink-alcohol-on-trt)

Reference

Pencina KM et al. Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men with Hypogonadism. J Clin Endocrinol Metab. 2024. https://doi.org/10.1210/clinem/dgad484 (https://doi.org/10.1210/clinem/dgad484) · PubMed 37589949 (https://pubmed.ncbi.nlm.nih.gov/37589949/).

Next step

Start a free consult in Utah (https://a2ztrt.com/contact). Bring your questions — including anything this study raised for you.

The TRT program is $149/month and includes initial labs only. Tadalafil and enclomiphene, sermorelin, and tirzepatide (compounded, not FDA-approved) are separate products.

Talk to a licensed provider. Results vary. Not medical advice.