Do low testosterone levels cause ED?

Reviewed by Dr Bhavini Shah

When it comes to men’s health – and particularly sexual health – a lot of emphasis tends to be put on testosterone. As we age, lots of men worry that their testosterone is getting too low and that this is the cause of unwanted changes to our bodies, as well as problems in the bedroom like erectile dysfunction (ED).

In this article we’ll explore if low testosterone levels cause ED as well as the ways you can influence your testosterone levels.  

What is testosterone?

Testosterone is a vital hormone in males and females. If a young boy is lacking testosterone, then the normal “masculinisation” that occurs during puberty won’t happen i.e. their genitals won’t grow, and their voice won’t drop.

In males, testosterone enables normal sexual development. It’s also linked to:

• sex drive
• sperm production
• fat distribution
• red blood cells
• the strength and size of our bones and muscles 

In adult men, testosterone remains an important hormone. Amongst other things, it’s important for maintaining a healthy sex life and staying fertile. 

Testosterone and erectile dysfunction

There are numerous studies exploring the link between low testosterone and ED, but more research needs to be done. Testosterone can be associated with changes in sex drive, these can play a part in erectile dysfunction. This is because low sex drive can make getting and keeping an erection difficult.

However, ED can be caused by other factors, not just low testosterone, throughout a man’s life.

What else could be causing erectile dysfunction?

ED can be caused by a variety of physiological and psychological conditions such as:

• High blood pressure
• High cholesterol
• Hormonal imbalance
• Nerve problems
• Stress
• Depression
• Relationship issues
• Performance anxiety
• Being overweight
• Alcohol use
• Smoking 

Find out more about what can cause erectile dysfunction.

The impact of different levels of testosterone

Testosterone levels can fluctuate creating different symptoms and health conditions.

Low levels of testosterone and ED

Low levels of testosterone can contribute to ED, as testosterone plays a role in a range of functions such as libido and the bodily processes involved in getting an erection. Low levels can also impact a person’s mood which in turn can cause ED.

While it’s true that some conditions can cause abnormally low testosterone, most of us have completely normal and healthy amounts, even as we get into our later years. This means that any symptoms you’re experiencing, or ED are far more likely related to other factors to do with the ageing process, or underlying conditions that have gone undiagnosed.

High levels of testosterone and ED

High levels of testosterone are typically not associated with erectile dysfunction (ED). Testosterone is a hormone that plays a key role in maintaining libido (sex drive) and overall sexual function in men. However, there can be some exceptions and nuances to this general rule.

While low testosterone levels can contribute to ED, having high levels of testosterone doesn't necessarily mean a person will have better sexual function.

Testosterone levels over time

As we age, our testosterone levels naturally decrease – but not as much as most people think. Between the ages of 30 and 40, testosterone will begin to decline, normally at a rate of less than 2% a year. 

In short, many men will have all the testosterone they need to stay healthy and enjoy a normal sex life as they age. 

What causes testosterone deficiency?

Most men maintain sufficient testosterone levels as they age. However, some men might develop a testosterone deficiency - a condition called hypogonadism. Low testosterone can be caused by a range of factors such as:

• Injury to the testicles
• Chemotherapy or radiotherapy
• Mumps
• HIV/AIDS
• Undescended testicles 

What is hypogonadism?

Hypogonadism is where the testes produce very little, or even zero, hormones, leading to a testosterone deficiency. Occasionally hypogonadism can develop later in life, especially in men who have type 2 diabetes or are obese.

Symptoms of low testosterone

The symptoms of low testosterone caused by hypogonadism include:

• Decreased sex drive
• Less energy
• Depression
• Erectile dysfunction
• Infertility 

In adult men, low testosterone can also cause a loss of facial and body hair, a decrease in muscle mass and bone mass, and the development of breast tissue. Find out more about the symptoms of low testosterone.  

How to test for low testosterone

A blood test can check your level of testosterone. You can check your testosterone levels at home with a blood test, such as our men’s health blood test. This blood test also checks cholesterol levels, liver function and diabetes risk. Find out more about how to test testosterone levels at home. 

If you’re experiencing symptoms, you should speak to your GP. They may recommend a blood test to measure your testosterone levels. If your blood test results show that you have a testosterone deficiency, your GP may refer you to a hormone specialist. If they confirm that you have low testosterone you may have hormone replacement therapy.

Treatments for low testosterone

Speak to your GP if you think you may have low testosterone. They’ll talk through available treatments such as testosterone replacement therapy. This can be taken as a pill, patch, gel or injection. This treatment aims to improve the symptoms of low testosterone. Your testosterone levels will be measured to see if the treatment is working.

Your GP will possibly also recommend lifestyle changes such as:

• Regular exercise
• Stress management
• Eating a balanced diet
• Drinking less alcohol 

“Living a healthy lifestyle with regular exercise and a healthy balanced diet may help with your symptoms.” - Dr Bhavini Shah

You may have heard about other home remedies and supplements that can boost testosterone levels. Often these products have little scientific evidence to back them up. They can even be dangerous.

Can you boost testosterone naturally?

You may have heard about testosterone boosters. If you’re experiencing erectile dysfunction, trying natural remedies said to “boost your testosterone” is unlikely to do anything other than put a dent in your bank account.

Instead, you should visit your GP to talk through your symptoms, they may want to do a blood test to check your testosterone levels.  You can also do this at home with a men’s health blood test. Your GP will also be able to find out the cause with a blood test, and to get some effective treatment.

Treatments for erectile dysfunction

ED affects around half of all men between the ages of 40 and 70 it’s often dismissed as a natural part of ageing. However, ED that’s a recurring problem might be a sign of an underlying physical condition that needs to be addressed, like cardiovascular disease or diabetes. Alternatively, it might be a sign of depression or anxiety, or a problem in your relationship.

ED that happens every now and then is usually nothing to worry about – especially if it tends to occur when you’re very tired or you’ve had a lot to drink.

If you’re regularly having trouble getting an erection, it’s a good idea to see your GP. They’ll be able to run some tests to work out the cause and, if appropriate, give you some medication.

For most men, however, the standard treatment is ED tablets such as:

• Viagra
• Cialis
• Tadalafil
• Sildenafil
• Vardenafil
• Levitra
• Viagra Connect

Although these won’t cure the root cause of your impotence, they can be a safe and effective way to temporarily achieve an erection. Regularly exercising, eating a healthy balanced diet rich with vitamins and stopping smoking can help too. 

You can order of ED tablets through our Online Doctor service. Simply fill out a short, confidential questionnaire and wait for one of our in-house clinicians to check through your answers to make sure you’re suitable for treatment. Once we’ve approved your order, we’ll deliver your tablets to your home or make them available to collect at your local ParcelShop.

Does Viagra work with low levels of testosterone?

Viagra (sildenafil) is a medication used to treat erectile dysfunction (ED) by increasing blood flow to the penis during sexual stimulation.

If someone with low testosterone levels and ED uses Viagra or other ED treatments it may still help them achieve an erection. However, addressing the causes of low testosterone may also improve symptoms of ED. If you are taking Viagra for ED but are still having difficulty getting and keeping erections, speak to your GP.

Conclusion

Erectile dysfunction can be caused by many factors, and the link between the condition and low testosterone is complex. If you think you may be experiencing low testosterone speak to your GP, you could also do an at home blood test to check your levels. Your GP can talk you through available testosterone and ED treatments as well as lifestyle changes that can help.  

References

https://www.nhs.uk/conditions/male-menopause/
https://www.health.harvard.edu/drugs-and-medications/testosterone--what-it-does-and-doesnt-do
https://patient.info/mens-health/erectile-dysfunction-impotence/testosterone-deficiency
https://www.mayoclinic.org/diseases-conditions/male-hypogonadism/symptoms-causes/syc-20354881
https://www.baus.org.uk/patients/conditions/3/erectile_dysfunction_impotence/
https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706091/