Erectile dysfunction, often known as ED, is a common sexual problem that affects men of all ages for a wide variety of reasons. To put it simply, if you have ED, you're unable to get or maintain an erection that’s firm enough for sex.
Some men who have ED also find that their sex drive — often called libido — is reduced as well. You may find that your interest in sex isn't as intense as it used to be or that you're not getting erections as often. This can sometimes be related to your ED, and it can also be a result of low testosterone.
ED can be caused by a variety of physical illnesses, but it can also be caused by mental health problems, or even a combination of the two.
Some physical causes include:
● Low testosterone
● Heart disease
● High cholesterol
● High blood pressure
● Certain prescription medications
● Tobacco use
● Alcoholism and substance abuse
● Treatments for prostate cancer or enlarged prostate
● Injuries to certain parts of your body
Mental health issues that might lead to ED include depression, anxiety, stress, and relationship problems. If these are combined with some of the above physical issues, it can make your ED worse.
On top of that, some of these issues have a cascading effect, causing other issues that themselves cause ED.
Other Issues That Can Cause ED
For example, alcoholism can directly cause ED, but it can also cause heart problems that then lead to ED, and it can also lower testosterone levels at the same time, which by itself can cause ED.
Even if the alcoholism is treated, the ED may remain if the heart issues aren’t resolved or testosterone levels aren’t returned to normal.
These issues can also feed into each other. Obesity is an example of this — fat can act as an estrogen-producing organ, which can lead to lower testosterone levels, which then makes it harder to lose weight in the first place.
Continued obesity can cause heart issues, which then make it harder to exercise and lose weight. The problems compound, making the treatment of ED that much harder.
Experiencing occasional ED isn't necessarily a cause for concern. However, if ED is an ongoing issue, it can stress you out, affect your self-confidence, and contribute to relationship problems.
It might also be a sign of a more serious health issue that requires treatment, including abnormally low testosterone levels, which can often be easily treated with testosterone replacement therapy (TRT).
TRT has the added benefit of short-circuiting some of the above issues. People who suffer from obesity often find weight loss much easier when their testosterone levels are balanced. The same can be said for heart issues — testosterone has been found to have a protective effect on the heart.
What Testosterone Does for You
Testosterone performs many roles in your body, but one of the main things it does is give you a sex drive. On top of that, your testosterone levels can influence mood and energy levels, both of which can play a role in causing ED.
As you age, your testosterone levels naturally decline. This typically starts around age 30 and continues at a rate of about 1% per year. However, some men experience a more significant decrease in testosterone levels, which can lead to symptoms such as fatigue, depression, decreased sex drive, and ED.
While a decrease in testosterone levels is a natural part of aging, abnormally low levels can cause health problems. This condition, known as hypogonadism or low testosterone, can be diagnosed through a simple blood test and is often treatable through testosterone replacement therapy.
The Correlation Between Testosterone and ED
There is a clear link between testosterone and ED. Testosterone is essential for maintaining a healthy sex drive and getting a strong erection regularly. However, the relationship between testosterone and ED isn't as straightforward as it might seem.
Studies have shown that while low testosterone can lead to decreased sex drive, it's not always the primary cause of ED. Some men with ED have what would be considered “normal” testosterone levels.
There are two problems with this idea. First, what’s “normal” for one man is abnormal for another. If your body regularly produced 950 ng/dL of testosterone when you were younger, but now you only have 400 ng/dL, a doctor might consider that to be in the “normal” range, but you would likely experience the symptoms of low testosterone.
On top of that, what counts as ED is subjective and relative. While you may be able to maintain an erection long enough to have sex, you and your partner may not be happy with how strong it is — it might be barely sufficient — but a doctor might say you don’t have ED because you’re able to have sex.
Other Treatments for ED
If testosterone replacement therapy isn’t the right fit for you, or if it doesn't improve your ED symptoms as much as you’d like, there are other treatments available. These include oral medications, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn), which work by increasing blood flow to the penis.
There are also non-drug treatments for ED, including vacuum erection devices, penile implants, and vascular surgery. In addition, counseling can help if your ED is caused by stress, anxiety, depression, or relationship problems.
Lifestyle changes can also help improve ED symptoms. These include quitting smoking, drinking less, getting regular exercise, and eating a healthy diet. It’s also possible some of your medications are causing your ED — talking to your doctor about switching to other medications might help as well.
Talk to Your Healthcare Provider About Testosterone and ED
If you're experiencing symptoms of ED, it's important to talk to a trained healthcare provider. While it might feel embarrassing, remember that ED is a common problem and that it can often be treated.
During your appointment, your provider will likely ask about your symptoms, medical history, and any medications you're taking. They'll also perform a physical exam and order blood tests to check your testosterone levels.
If your testosterone levels are low, your provider might recommend testosterone replacement therapy. However, this treatment isn't right for everyone — for example, TRT can cause infertility, so men who plan to have children might not want to take it.
It's important to discuss the potential risks and benefits with your healthcare provider and find a solution that’s right for you.
Experiencing Erectile Dysfunction? We Can Help
To learn more about testosterone replacement therapy and discuss your options for treating your ED, schedule an appointment today.