Low T and ED
It is estimated more than half of men over 40 will develop erectile dysfunction as they age.1 39% of men over the age of 45 will also develop low testosterone.2 There is certainly a gradual age-dependent reduction in testosterone production in healthy men; but for many men, their natural testosterone production gets well below what would be considered normal at their age.2
I am sure you have heard commercials advertising low testosterone treatments and how they can cure all your problems. It is true, testosterone is connected to a lot of important aspects of a man’s overall health. For example, low testosterone can cause fatigue, low libido, and even erectile dysfunction like we are talking about today.2 Low testosterone is also associated with loss of muscle mass, gaining weight or fat mass, depressed mood, and poor mental focus.2 Long-term low testosterone levels are connected with osteoporosis, or thinning of the bones, cardiovascular disease, insulin resistance, and diabetes.3
Testosterone is vital for general men's health and wellness. Specific to erectile dysfunction, normal testosterone levels may ensure that the erectile function process occurs.2 This means that men can often still get erections and have low testosterone, but perhaps erections are not as firm as they used to be or do not last as long as they used to last.1
An erection that occurs naturally requires stimulation, which means that there must be a connection between the brain and the penis, and this connection is in part bridged by testosterone.1 There are men who have erectile dysfunction and have tried medications to treat erectile dysfunction, such as Viagra® or Cialis®. If pills are not effective in those men, we check their testosterone levels and if their testosterone levels are low, we put them on testosterone treatment. As a result, their erectile dysfunction might improve.2
If men with severe erectile dysfunction in which there is a significant limitation to blood flow into the penis because of vascular disease or diabetes, then testosterone, even if it's low, may not be the only answer to improve their erectile function. I view my role in treating patients with erectile dysfunction as trying to identify all the potential causes and, if possible, eliminating those causes to the best of my ability. For my patients, checking testosterone levels and reviewing the possible symptoms of low testosterone is a routine part of my practice in optimizing my patients’ erectile function.
If you or a loved one might be experiencing symptoms associated with low testosterone or erectile dysfunction, please visit EDCure.org to learn more, or visit TheMensMD.com to request an appointment for a thorough evaluation with me. There are many reasons for ED, including low testosterone. You can take a simple erectile dysfunction quiz to help you assess the severity of your ED by visiting EDCure.org/understanding-ed/ed-assessment.
References
- Feldman HA, Goldstein I, Hatzichristou DG, et al. Impotence and its medical and psychosocial correlates results of the Massachusetts Male Aging Study. J Urol. 1994 Jan;151(1):54-61.
- Mulligan T, Frick MF, Zuraw QC, et al. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006 Jul;60(7): 762-9.
- Bashin S, Cunningham G, Hayes F, et al. Testosterone therapy in men with androgen deficiency syndromes: An Endocrin Society clinical practice guideline. J Clin Endocrin Metab. 2010 Jun;95(6):2536-59.
EDCure.org is a website sponsored by Boston Scientific.
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J. Abram McBride, MD is a paid consultant of Boston Scientific.
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