Testosterone is a hormone in men that plays a crucial role in functions such as stimulating sperm production and boosting libido, which triggers erections. Many may wonder whether there is a direct relationship between hormone levels and impotence in men. In this article, you’ll find out everything you need to know about testosterone and its role in men’s health. It also addresses the common question: does low testosterone cause erectile dysfunction? Let’s dive in.
What Is Low Testosterone (Low T)?
Testosterone, the main sex hormone in males, is responsible for the development of sexual tissues such as the prostate and testicles. Beyond its foundational role in shaping male anatomy, it also imparts distinctive features such as increased muscle and bone mass and a deeper voice. Primarily produced in the testicles, the hormone plays a role in regulating libido and overall sexual function [1].
During puberty, parts of the brain called the hypothalamus and pituitary gland increase the production of testosterone. The increased levels in the body then cause the male reproductive tissues to mature, marking the transition from adolescence to adulthood. In some unusual circumstances, the testicles fail to produce enough testosterone during adulthood. This condition is often referred to as low testosterone (low T). While it doesn’t universally affect everyone, this condition can indeed influence libido. Several factors can contribute to low testosterone levels, which will be further explored in the following sections, along with its possible causes and signs.
The Role of the Hormone Testosterone for Men’s Health
Testosterone plays a pivotal role in males during and after puberty. During puberty, it aids in the transition from adolescence to adulthood via the following changes [2]:
- growth of the penis and testicles;
- deepening of the voice;
- strengthening of muscles and bones;
- increase in height;
- development of facial, pubic, and body hair.
After puberty, the hormone helps in the regulation of fat distribution, bone density, and sperm production. It also influences arousal and sex drive and ensures the proper functioning of the overall reproductive system.
Beyond its influence on key physical characteristics such as the development and regulation of the reproductive tissues, testosterone affects some behavioral aspects such as stress response, risk-taking behavior, aggression & assertiveness, and cognitive abilities. By defining masculine traits and promoting a balanced psychological state, the hormone may contribute to the overall well-being and quality of life for men when maintained at appropriate levels.
Causes and Signs of Low Testosterone
As men age, there is a general tendency for testosterone levels to decline. Typically, this decline is characterized by an approximate 1% reduction per year after reaching the age of 30. Besides age, several other factors can contribute to low T in men. Some of them include [3][4]:
- medical conditions: Obesity, hypogonadism, and testicular injuries can affect the body’s ability to produce enough testosterone. Other factors such as heart failure, autoimmune diseases, and diabetes can also influence testosterone levels in boys and men;
- medications and treatments: Some drugs can interfere with the testicle’s ability to produce sufficient testosterone for the proper functioning of the reproductive tissues and the overall men’s health. Some of them include corticosteroids, opioids, and drugs used for cancer treatment. Radiation therapy may also affect testosterone levels;
- lifestyle factors: Poor lifestyle choices such as lack of proper sleep, excessive alcohol intake, and lack of regular exercise can cause testosterone levels to drop. Poor nutrition may also contribute to low T. For example, regularly eating foods high in processed sugars and saturated fats can lead to obesity, which causes a drop in testosterone levels.
Causes of low T can vary from one man to another, and sometimes it may not even be known. However, it is important to recognize symptoms and seek help to ensure proper care and treatment. Here are some signs and symptoms that may be an indication of low T [2]:
- low energy levels;
- low sex drive;
- erectile dysfunction;
- low sperm count;
- depressed mood;
- fertility problems;
- ejaculation problems;
- enlarged or tender breasts;
- insomnia;
- loss of muscle and bone strength.
While the above-listed symptoms are common among middle-aged men or seniors, those likely to show up in younger males include delayed puberty, underdeveloped genitalia, lack of facial hair, and other secondary sexual characteristics.
Recognizing the signs and symptoms of low testosterone levels early is crucial for timely and effective treatment or management. If you suspect you have low T, it is important to visit a doctor for a proper evaluation. Diagnosis typically involves a blood test to measure its levels in the body. In most cases, doctors typically adopt treatment options such as testosterone replacement therapy (TRT), addressing any underlying medical conditions that may be causing it and making lifestyle changes [5].
What Is Erectile Dysfunction (ED)?
Erectile dysfunction is a condition characterized by the inability to achieve and sustain an erection sufficient for penetrative sex. It is one of the most common conditions in men, as it affects about 150 million men worldwide. Contrary to popular belief, ED does not only affect seniors. While it is more common in men over 40 years of age, it also affects younger males. To put this in perspective, around 8% of males between the ages of 20 and 29 experience it, and 11% between the ages of 30 and 39 [6][7].
Regardless of the age at which one experiences this condition, it is important to seek treatment as soon as possible, as it can be a sign of more serious underlying conditions. At this point, it is worth noting that experiencing erection troubles from time to time isn’t a cause for concern. However, if it persists, it may be time to seek medical attention. Your doctor may recommend treatment options such as hormone therapy (if you have low T), penile implants, psychological counseling, vacuum erection devices (VEDs), lifestyle changes, or medications.
While drugs like Cialis, Viagra, and Levitra are easily accessible and proven effective, it is important to use them correctly. Misuse may render meds ineffective or result in unwanted side effects. Never snort Cialis or any ED drugs, as they are to be swallowed whole with a substantial amount of water. It is advisable to consult a doctor before starting treatment with any medication.
Links Between Low Testosterone and ED
The prevalent question among many men dealing with ED is, How does low testosterone affect a man? This thought is often fueled by the fact that about 1 in 3 men with ED also have low testosterone levels. However, it is worth noting that the sexual disorder is not directly linked to testosterone levels. While it is common for males with ED to also have low T, in many cases, individuals with low testosterone levels may not experience any difficulties achieving and sustaining an erection for penetrative sex. Similarly, having high T levels does not guarantee heightened sexual function.
Low T levels, while not a direct cause of ED, may exert an indirect influence. Here are several contributing factors to consider [8]:
- low libido: Erections are as mental as they are physical. This simply means that erections start in the brain with a man thinking about engaging in sexual activity, which ultimately results in arousal. Because testosterone influences or fuels thoughts, when its levels drop, it can reduce sexual desire and an overall interest in sexual activity. This can contribute to difficulties in achieving and sustaining an erection;
- stress: Low T levels may result in decreased energy levels, potentially leading to increased stress. This heightened stress can make it difficult to achieve and keep an erection and may also discourage you from engaging in sexual activity.
What’s more, an overlap of several factors influenced by low T levels can lead to ED. For example, low T levels can cause fatigue, which can discourage you from exercising, which then increases the risk of weight gain and heart disease, among other conditions that are associated with ED.
Does Low T Really Cause Erectile Dysfunction?
There is a link between low T and erectile dysfunction. This is evident in the fact that artificially boosting testosterone levels beyond what the body needs (via the use of steroids or TRT) may cause hormonal imbalances that have been seen to affect libido and ultimately erection. However, it is worth noting that the relationship is a bit intricate, and the effects may vary from person to person [9].
Low T is a contributing factor, but in most cases, it is not the sole cause of impotence in men. Many males with ED have normal testosterone levels. Also, addressing the hormone alone may not be enough to resolve ED. To effectively manage the condition and improve sexual performance, it is advisable to consult a healthcare professional. They can identify the specific factors causing the sexual disorder, enabling them to tackle it effectively.
When to Ask for Help?
Not all men, especially those with age-related low T, have ED or other symptoms affecting their quality of life. What’s more, symptoms such as fatigue and insomnia can be a result of factors other than low testosterone levels and may not be serious. However, there are certain situations in which it becomes crucial to seek medical attention from a healthcare professional. Here is a general guideline on when to ask for help:
- if the symptoms are persistent;
- if you’re experiencing anxiety, changes in mood, or other mental health concerns;
- if you notice new or worsening symptoms, especially if they are interfering with your day-to-day activities or causing distress;
- if you experience changes in libido or constant difficulties (in at least 50% of attempts) getting and sustaining an erection [10].
Seeking help early enough can significantly improve treatment outcomes. This is simply because it allows for early diagnosis and intervention. Your doctor or healthcare provider is in the best position to provide tailored assistance based on your specific health needs.
In Closing
As a man sexually struggling to get and sustain an erection, it is quite normal to suspect low testosterone levels to be the culprit. This is due to the sheer number of cases, which sits around 33%, in which men with ED also happen to have low T. Even if an individual with ED has low testosterone levels, taking drugs or receiving other forms of treatment to increase its levels may not improve erections. If you’re experiencing difficulty achieving and sustaining an erection, the best thing would be to consult a doctor for proper diagnosis and treatment. Avoid self-prescribing medications to increase testosterone levels without professional guidance. ED meds such as Cialis may be all you need. But whatever the case may be, it is best to let your doctor decide.
References
- Testosterone. Retrieved: December 13, 2023. Wikipedia.org.
- Testosterone: The Male Hormone Impact on Men’s Health. By Cathy Garrard. Medically reviewed by Michael Natter, MD. Retrieved: December 13, 2023. Everydayhealth.com.
- Testosterone Levels by Age: Normal Levels, Low T Sings, Women & More. By Alexia Severson. Medically reviewed by Daniel Murrell, M.D. Retrieved: December 13, 2023. Healthline.com.
- Low Testosterone Causes. By Ingrid Strauch. Medically reviewed by Robert Jasmer, MD. Retrieved: December 13, 2023. Everydayhealth.com.
- What Can Help with My Low Testosterone? Retrieved: December 13, 2023. Urologymedicalgroup.com.
- Erectile Dysfunction – Symptoms and Causes. By Mayo Clinic Staff. Retrieved: December 13, 2023. Mayoclinic.org.
- Erectile Dysfunction in Young Men: Causes and Treatments. By Jenna Fletcher. Medically reviewed by Matt Coward, MD, FACS. Retrieved: December 13, 2023. Medicalnewstoday.com.
- Does Low Testosterone Cause Erectile Dysfunction? Retrieved: December 13, 2023. Health.clevelandclinic.org.
- Does Low Testosterone Cause ED? By Austin Letorney. Medically reviewed by Wagner Baptiste, M.D. Retrieved: December 13, 2023. Honehealth.com.
- Erection Problems: Causes, Treatment, Complications & Prevention. By Darla Burke. Medically reviewed by Alana Biggers, M.D. Retrieved: December 13, 2023. Healthline.com.
