Testosterone Therapy for Erectile Dysfunction

Written by Medical experts of the National HRT Clinic - August 3, 2016

There is nothing worse for a man than hearing that some form of erectile dysfunction (ED) is normal. Being told it is “all in your head” might be even worse. That type of conversation can help propel a man towards depression, a situation already at risk if he is dealing with testosterone deficiency. There are multiple reasons to consider using testosterone therapy for erectile dysfunction, and we will discuss them today – as well as dispel the myths.

• Myth #1 – Testosterone replacement therapy for erectile dysfunction does not work.

That is true and false. If a man does not have symptoms of low testosterone, then it is likely that his ED is caused by other issues. Testosterone replacement therapy (TRT) will most likely not work for him. However, if he does have symptoms of Low T along with erectile dysfunction, then there is a good chance that TRT will help restore better erectile functions.

• Myth #2 – Testosterone treatment for erectile dysfunction will work for all men with Low T.

That is not true. Even though a man is diagnosed with testosterone deficiency, his ED may have other causes. If so, testosterone therapy may only help the other Low T symptoms and not restore erectile function.

What is Erectile Dysfunction – Overview

Erectile dysfunction is an inability for a man to achieve or maintain an erection that can sustain satisfactory sexual performance. A man may also view the disappearance of his morning erections or lack of multiple erections in one night as a sign of ED. For some men who receive testosterone replacement therapy, male erectile dysfunction becomes a thing of the past. Others are not so lucky, especially if their ED is rooted in some other cause.

Here are the symptoms and causes of erectile dysfunction:

Symptoms:

• Decreased sexual desire
• Slow or impaired sexual arousal
• Difficulty achieving an erection
• Softer erections
• Trouble sustaining an erection for satisfactory sexual activity
• Reduced penile sensitivity

Causes:

• Atherosclerosis – clogged or blocked blood vessels inhibiting circulation
• Depression
• Diabetes
• Heart disease
• High blood pressure
• High cholesterol
• Injury to the penis, or other areas that impact nerves or arteries that control erectile functions
• Metabolic syndrome
• Multiple sclerosis
• Obesity
• Parkinson’s disease
• Peyronie’s disease – scar tissue develops inside the penis
• Sleep disorders including sleep apnea
• Surgery or other treatment to the penis, prostate, pelvic, or spinal areas
• Testosterone deficiency

Certain medications, alcohol and tobacco use, relationship problems, and stress can also affect erectile functions.

Erectile dysfunction can also result in the following complications:

• Infertility and the lack of pregnancy
• Problems in a relationship
• Anxiety or stress
• Depression
• Low self-esteem
• Embarrassment
• sex life

The use of testosterone therapy for erectile dysfunction will not help in all the causes listed above, but it will be a factor for improvement in many of them.

Is Testosterone Deficiency the Cause of Erectile Dysfunction?

We want to explore the facts around the need for testosterone therapy & causing erectile dysfunction in men as they age. Testosterone has many contributing factors in this situation.

• First, testosterone supports healthy bone marrow and red blood cell production (which begins in the bone marrow). If a man has Low T, his blood cell production may decline, causing circulation issues. Impaired circulation reduces blood flow to the sexual organs, resulting in an inability to achieve a firm erection.
• Testosterone also helps maintain a healthy HDL to LDL cholesterol ratio. HDL cholesterol sweeps excess LDL cholesterol from the bloodstream. If HDL levels are low, LDL may increase, leading to a buildup of arterial plaque. The result is atherosclerosis – one of the leading causes of ED. The arteries become clogged, and blood flow to the pelvis decreases.
• Hormone levels decline with age, including testosterone. You can see how Low T levels influence the above issues. However, there is more. We have to look at the role of the endothelium in contributing to erectile functions and why there are benefits of using testosterone therapy for erectile dysfunction.

The endothelium is the lining of the heart, blood vessels, and lymphatic vessels. Endothelial cells affect vascular tone and also release nitric oxide (NO) into the bloodstream. NO is responsible for relaxing smooth muscle cells and increasing blood supply, including to the penis. In this situation, the connection between testosterone therapy and erectile dysfunction becomes clear because atherosclerosis, caused by plaque buildup that often accompanies Low T, inhibits NO release. When the endothelial vasculature is healthy, blood flows freely, and plentiful NO is released to support erectile functions.

Furthermore, low testosterone levels are associated with oxidative stress, an imbalance of free radicals and antioxidants that can cause tissue and cell damage, including in the penile vasculature.

These are only some of the ways that testosterone influences erectile functions. If it is true that low testosterone impairs the penis as explained, can supplemental testosterone cure erectile dysfunction in men with Low T?

According to the results we have seen, along with extensive research, the answer for some men is yes, testosterone therapy can put an end to the symptoms of ED. It is essential to remember that TRT does not work for all cases of erectile dysfunction, but it can help many men (and their partners) improve their sexual satisfaction.

When Should Testosterone Be Considered for Erectile Dysfunction Treatment?

If you want to know is testosterone good for erectile dysfunction in your situation, the only way to find out is with a comprehensive blood test and physical examination. Unless you have other symptoms of Low T, such as fatigue, weight gain, muscle loss, insomnia, and high cholesterol, testosterone will probably not be the answer you seek. Of course, you do not need to have all the symptoms associated with testosterone deficiency to be diagnosed with Low T. The list of low testosterone symptoms is extensive, and we recommend you refer to it to determine if testing is warranted. We suggest that all men who have at least three Low T symptoms undergo a blood test and examination.

If you are diagnosed with Low T, then the use of testosterone replacement for erectile dysfunction as well as a reversal of testosterone deficiency symptoms is warranted.

It does not take long for testosterone therapy for erectile dysfunction to go to work, improving the quality of your life – and sex life. The sooner you seek treatment, the sooner you will have a satisfactory sex life again.

Testosterone Therapy for Erectile Dysfunction

Yes, erectile dysfunction may be a “natural” part of the aging process, with over 50% of men between ages 40 and 70 reporting some form of ED at some point. However, that does not mean there is nothing you can do about it. Turning to testosterone therapy for erectile dysfunction if you have other symptoms of Low T may be the right choice for you.

Here at National HRT, we are often asked about the best testosterone for erectile dysfunction. Our answer is this: the treatment options are different for each man, depending on his level of testosterone deficiency and personal situation. We will not know this until reviewing the results of the physical exam and blood test.

What we can tell you is that we have found that the use of a testosterone injection for erectile dysfunction, such as testosterone cypionate or testosterone enanthate, is often the best choice. When injected into a muscle, such as a thigh, the testosterone is easily absorbed into the bloodstream where it can go to work. Transdermal testosterone does not have the same level of absorption.

Medically reviewed by   National HRT Staff - Updated on November 4, 2024

Please note that the information provided in this article is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

References

References

1. Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men Paul J. Rizk, a Taylor P. Kohn, an Alexander W. Pastuszak,b,c, and Mohit Kherab Curr Opin Urol. Author manuscript; available in PMC 2018 Nov 1.Published in final edited form as Curr Opin Urol. 2017 Nov; 27(6): 511–515.
2. Testosterone replacement therapy in males with erectile dysfunction. Jacob BC.J Pharm Pract. 2011 Jun;24(3):298-306. Epub 2011 Mar 31.
3. International Society for Sexual Medicine
4. Testosterone Therapy in Erectile Dysfunction and Hypogonadism Ridwan Shabsigh, MD1,*,’Correspondence information about the author MD Ridwan Shabsigh To read this article in full, please review your options for gaining access at the bottom of the page. November 2005Volume 2, Issue 6, Pages 785–792
5. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1464-410X.2007.06756.x
6. Does Testosterone Have a Role in Erectile Function? Nasser Mikhail, MD, MSc MD, MSc Nasser Mikhail May 2006Volume 119, Issue 5, Pages 373–382
7. A Critical Analysis of the Role of Testosterone in Erectile Function: From Pathophysiology to Treatment—A Systematic Review Andrea M. Isidoria Jacques Buvatb, Irwin Goldsteind Emmanuele A. Janninie Andrea Lenzia Hartmut Porst Andrea Saloniag Abdulmaged M. Mario Maggii,l Traishh Available online 11 December 2015.
8. MAYO CLINIC

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