Erectile Dysfunction Treatment — Understanding the Role of Testosterone

August 1, 2021
While erectile dysfunction (ED) can have various causes, one possible cause is low testosterone. Before determining the exact cause of your ED, your doctor will first have you fill out a medical history and perform a physical exam. You will then be able to decide on the best form of erectile dysfunction treatment. ED is when a man is either not able to get an erection, cannot keep an erection going, or both. ED can be immensely disheartening to men, which is why so much time and effort has gone into the study of ED. The problem with ED is that, in many cases, doctors only prescribe drugs like Viagra and send patients on their way. We know that ED is a complex issue that can have a wide variety of causes, one of which can be low testosterone. One possible form of erectile dysfunction treatment is testosterone replacement therapy. A health professional might recommend this as the first step in treatment or combine it with other therapies.

Types of Erectile Dysfunction Treatment

Once your doctor has determined the cause and severity of your ED, you will be able to explore various erectile dysfunction treatment options. Your doctor should cover the risks and benefits of each so you can determine which course of treatment you think would be best. In addition, you also might want to discuss these options with your partner. Oral Medications Four major medications that doctors may prescribe are sildenafil (Viagra), tadalafil (Adcirca, Cialis), vardenafil (Levitra, Staxyn), and avanafil (Stendra). Taking one of these medications will not automatically allow an individual to produce an erection. These tablets enhance the effects of nitric oxide, which allows you to get an erection once you are exposed to sexual stimulation. Each medication will work for varying lengths and produce different side effects such as nasal congestion, flushing, headache, backache, visual changes, and nausea. Other Medications Another form of erectile dysfunction treatment is self-injecting alprostadil (Caverject, Edex). The patient will inject this medication into the base or the side of the penis. Each injection is pharmaceutically produced to create an erection that will last no longer than an hour. Side effects can include priapism (prolonged erection), mild bleeding from the injection, and the formation of tissue at the injection site in rare cases. Sometimes doctors will also recommend an alprostadil urethral suppository. This form of treatment involves placing a suppository inside your penis. The erection usually lasts between 30 and 60 minutes, and side effects can include minor bleeding or a burning feeling inside the penis.

Why Testosterone Replacement Therapy Can Help with ED

Testosterone plays a critical role in keeping and maintaining an erection. In our clinical practice, we’ve seen men who go on testosterone replacement therapy regain their ability to achieve and maintain erections. What we have to consider is why that happens. As we said earlier, the relationship between testosterone and ED is complex. Testosterone replacement therapy can directly affect (and sometimes treat) ED, but it can also help indirectly. That’s because ED can have more than one cause. Here are some possible causes of ED:
  • High blood pressure or high cholesterol
  • Obesity
  • Lack of interest in sex (low libido)
  • Relationship issues
  • Anxiety or depression
As you can see, ED can be caused as easily by a mental health issue as it can be a physical issue, like obesity. Here’s where the complexity of testosterone replacement therapy and its ability to treat ED comes into play. What we’ve seen in our clinical practice is that testosterone replacement therapy can treat some of these root causes, indirectly relieving ED. For example, testosterone replacement therapy can relieve mild anxiety and depression, which can cause issues in a relationship and reduce libido. Low testosterone itself can also directly reduce libido. When testosterone levels are restored to normal, libido may directly increase, which may help to relieve relationship issues that a lack of libido has caused. Similarly, if anxiety, especially around performance, or depression is reduced, men can find it easier to achieve and maintain an erection. Testosterone, in these cases, is treating a root cause of which ED is just a symptom. Yet another example comes with obesity. Low testosterone levels can cause obesity, a condition that can further reduce testosterone levels. Fat, especially visceral fat (fat in the abdominal area), can act as an estrogen-producing organ. Treating low testosterone has been shown to reduce body fat and increase muscle mass. Increased muscle mass further reduces body fat. As the body fat diminishes, endogenous testosterone (the amount of testosterone your body produces normally) can increase. Reducing obesity can then help reduce both high cholesterol and high blood pressure, both of which can cause ED. While Viagra and other drugs can help you achieve and maintain an erection, imagine if you could use an erectile dysfunction treatment that attacks the root cause itself and makes you feel like yourself again, rather than feeling like the only way you can perform is by taking a pill. Learn more about Low T, its causes, and testosterone replacement therapy here.