Dear Editor,rnWe read with interest the article by Zapata et al.1published in Asian Journal of Andrology. With data from 448 veteran men and using logistic regression analysis, this study the first time demonstrated that higher sexual function was associated with a decreased risk of prostate cancer. This association was hypothesized on that sexual dysfunction is a harbinger of heart disease, and prostate cancer and heart disease share similar risk factors; however, the mediation effect of testosterone (T) activity on the association can never be ignored. Although it has been discussed as one alternative explanation of the association in the article, in my opinion, it is not enough. Sexual dysfunction was a well-established clinical symptom of low serum T,2 and usage of T replacement therapy (TRT) which can increase serum T concentration of hypogonadal men to normal level can remarkably improve the symptom.