Erectile dysfunction is not uncommon after radical prostatectomy and men who undergo ADT in addition to this are likely to show further decline in their ability to engage in penetrative intercourse, as well as their desire to do so.  A study looking at the differences of using GnRH-A (and androgen suppressant) or an orchiectomy report differences in sexual interest, the experience of erections, and the prevalence of participating in sexual activity. Men reporting no sexual interest increased from % to % after orchiectomy, and from % to % after GnRH-A; men who experienced no erections increased from % to %; and men who did not report engaging in sexual activity increased from % to % after orchiectomy and % to %.  This study suggests that the GnRH-A and orchiectomy had similar effects on sexual functioning. A vicious cycle whereby lowering testosterone levels leads to decreased sexual activity, which in turn cause both free and total testosterone levels to decline even further.  This demonstrates the importance of androgens for maintaining sexual structures and functions.  
Androgens are responsible for the growth spurt of adolescence and for the eventual termination of linear growth, which is brought about by fusion of the epiphyseal growth centers. In children, exogenous androgens accelerate linear growth rates but may cause a disproportionate advancement in bone maturation. Use over long periods may result in fusion of the epiphyseal growth centers and termination of growth process. Androgens have been reported to stimulate the production of red blood cells by enhancing the production of erythropoeitic stimulating factor. During exogenous administration of androgens,Â endogenous testosterone Â release is inhibited through feedback inhibition of pituitary luteinizing hormone (LH).
Of the 34 patients in the study, 22(%) had their prostate volume increased, while 12(%) had it decreased. The change, however, was not statistically significant (p<). Mesterolone significantly improved Aging Male Symptoms, International Prostate Symptom and prostate-related quality of life scores (p<). These improvements though significant were independent of the changes in prostate volume. Total testosterone, sex-hormone binding globulin andestradiol decreased, while free testosterone showed no change (p<, p<, p<, p<). The fraction of free testosterone increased (p<), while total and free prostate-specific antigen did not change (p< and p<) CONCLUSION: Mesterolone proved to be a safe alternative in the treatment of Aging Male Syndrome. It also improved lower urinary tract symptoms and prostate-related quality of life.