Scott Braverman FNP-C
Scott Braverman FNP-CPeople like to make jokes about men with performance issues. They will say that the man is “not rising to the occasion” or has a “soft mast”. Of course, we’re talking about erectile dysfunction, aka ED, and finally answering the question: can low testosterone cause ED?
We’ve done the work, scoured the research, and inside this detailed guide, we’ll break down everything you MUST know about libido and testosterone.
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What is Testosterone?
Testosterone is known as the primary male sex hormone. testosterone is mostly found in men, but women also produce some of this hormone. In men, testosterone is biosynthesized from cholesterol in the body and produced by the Leydig Cells in the Testes. It plays a crucial role in male development and overall health. Having normal or slightly higher levels of Testosterone is crucial for male health, and is associated with the following characteristics [1]:
- Great Sexual function
- Cardiovascular health
- Feeling of well being
- Development of Male characteristics
- Increased muscle and bone density
As you can see from the list, it is rather important that men have healthy levels of Testosterone. Failure to have adequate levels of Testosterone in the body can have dire consequences, including muscle wastage, depression, and increased risk of cardiovascular disease [2, 3].
Testosterone and Libido
Testosterone plays a crucial role in men’s growth and development. Men produce testosterone in large amounts first when they are a fetus in the womb, and then again during puberty. Androgen levels are especially high in men and women during puberty. This rise in testosterone levels causes many bodily changes including oily skin, bodily hair growth, and increased sexual feelings [4]. Overall, Testosterone will play a vital role within the male body such as bone maturation, sperm production, and of course, sexual function [5].
There are two main ways to measure testosterone: free testosterone and total testosterone. Free testosterone refers to the amount of bioavailable testosterone in your blood. In other words, it measures how much testosterone is ready to interact with the rest of your body right away.
Researches have found that men who struggle with ED do have lower levels of free Testosterone in their bodies [6]. Healthy testosterone levels are critical for sexual arousal and for achieving and maintaining an erection. Testosterone actually stimulates the penis to produce more Nitric Oxide which can help achieve an erection as a vasodilator [7].
Can Low Testosterone Cause ED?
The short answer is yes, low testosterone can cause erectile dysfunction. Testosterone plays a crucial role in men’s overall sexual health. It also plays an important role in intercourse as well [6, 7].
Older men are especially vulnerable to the effects of low testosterone and ED. Low Testosterone affects up to 36% of men over the age of 45, and there is a very clear link between low Testosterone and Erectile Dysfunction [8].
A study published in 2012 found that as men age, they have increasing levels of sex hormone-binding globulin (SHBG). This significantly lowers the amount of bioavailable testosterone, aka your “free testosterone.” They also found that there was a strong correlation between the lowering of free testosterone and increasing levels of ED [9].
So what role does testosterone play in achieving and maintaining an erection? The truth is testosterone acts as a vasodilator. In other words, it increases blood flow in the veins and arteries of the penis. This allows the penile arterioles and cavernous sinusoids to function optimally [10]. Testosterone also increases sexual urges and sexual health [8].
Studies have even found that Exogenous Androgens (Testosterone Replacement Therapy) will actually help men who have been castrated to have erections and healthy sex lives, even though they have zero Endogenous Testosterone [11].
Normal Testosterone Levels in Men
There are two main types of testosterone in the human body: total testosterone and free testosterone. Total Testosterone refers to the total amount of the hormone in the body, whereas free testosterone refers to the actual testosterone that is immediately available to bind to Androgen Receptors in the body. Free testosterone is the amount of testosterone that is not bound to one of two proteins: sex-hormone binding globulin (SHBG) or albumin.
Research shows that the healthy range for total testosterone is between 300 – 1,200 ng / dL. Men who have below 300 ng/dl of total testosterone may be at greater risk for negative health consequences, including erectile dysfunction. However, total testosterone does not tell the whole story. Your free testosterone levels are probably even more important when it comes to measuring your testosterone levels.
Research has shown that men suffering from ED often have normal total testosterone levels. However, they often have significantly increased shgb, or sex hormone-binding globulin [9]. Remember, the total testosterone test does not tell you how much bioavailable testosterone there is in the blood. This is why it is so important to test your free testosterone levels when you are suffering from symptoms of ED.
Free Testosterone Levels vs. Total Testosterone
For men suffering from symptoms of ED, free testosterone is probably a better measurement than total testosterone. While Total Testosterone will reflect the grand amount of Testosterone in the body, most of that will not be bioavailable due to SHBG. Here are the normal levels of free testosterone for men of different age ranges:
- 0-9 years – Less than 1 pg / mL
- 10-11 years – Less than 4 pg / mL
- 12-13 years – Less than 68 pg / mL
- 14-15 years – 2-95 pg / mL
- 16-17 years – 26-119 pg / mL
- 18 years and older – 32-168 pg / mL
Free Testosterone is the true reflection of how much Testosterone your body can actually use for sexual and other functions. So, while a Total Testosterone test might find you are within range, if you are still suffering from low Testosterone symptoms, then it may be a very good idea to check both your SHBG and Free Testosterone levels. High SHBG has been shown to be a massive factor in lowering Free Testosterone, and also increasing ED chances [9].
Sexual Signs of Low Testosterone in Men
Men with low testosterone levels often have negative side effects. Depression, loss of muscle mass, and depression are some of the most obvious signs of low testosterone. Other signs include:
- Failure to achieve an erection: free testosterone will help as a vasodilator in the penile tissue [10]
- Failure to maintain an erection: testosterone will act as a vasodilator, and without sufficient testosterone, it is likely to lose an Erection whilst engaged in sexual activity
- Low Libido: men who suffer from low testosterone will not only feel a lower sense of self-esteem, they will also be less likely to initiate sex and/or have low Libido [12]
- There are other ways that low testosterone can lead to impotence. Low testosterone has been linked to higher levels of hypertension, which has a strong link to ED [13, 14].
How to Test Testosterone Levels
There are many different signs of low testosterone levels, including failure to achieve or maintain an erection. If you think you are suffering from low testosterone, then one of the best steps to measure your testosterone is with a blood test. This will take guessing out of the formula and will give you a concrete answer. You can do this in two ways.
The first option is to go down to your local general practitioner, explain the symptoms that you are experiencing and ask if he or she can perform a blood test. This is a very safe option, but some people would like a more convenient solution.
The other method is going to be using an online testing company such as Let’s Get Checked. You choose the tests you’d like to be done, you send them your blood, and within a few days, you’ll have your results. Companies like these will provide various tests such as:
- Total testosterone
- Free testosterone
- Estradiol
They will also provide other tests that could reveal the reason you perhaps have low testosterone. For example, they often check thyroid hormones in their blood tests. Other tests provided include:
- Blood Lipids
- Thyroid Hormones
- Cortisol
If you are interested in using an online lab testing company then here is our top recommendation:
How to Increase Testosterone Levels Naturally
Higher testosterone levels are associated with better health outcomes, improved sexual performance, and increased overall quality of life. Therefore, it’s no surprise that many men are interested in ways to naturally raise their testosterone levels. Here are a few of your best options:
- Being Active: Studies have shown that resistance training will not only increase testosterone but growth hormone as well [15].
- Follow a Healthy Diet: Including variety and more protein in your diet has been shown to yield increased levels of testosterone [16]
- Supplementation: While not substantial, some supplements such as vitamin D can increase endogenous testosterone levels [17]
- Have more sex: Studies have shown that having more sex does lead to slightly higher levels of testosterone [18]
All in all, living a healthier lifestyle, decreasing blood pressure, eating healthier, and moving more is going to not only be beneficial for lifelong health, but Testosterone levels as well.
How to Increase Testosterone Levels with TRT
While trying to increase your testosterone levels naturally is a great idea, there are other effective options including testosterone replacement therapy. This treatment is particularly effective for men who suffer from low testosterone levels and will completely change their lives for the good. Having normal levels of Testosterone is vital not only for physical health but mental prosperity as well.
The way you do this is by having your testosterone levels tested (and declared low), and then finding a health practitioner to simply prescribe a testosterone replacement dose for you to follow. Not only will this raise free testosterone in the body and potentially erase all symptoms of ED, but it will improve your quality of life, cognitive function, and cardiovascular health.
The BEST Online TRT Clinic
While going to the doctor to get your TRT dose every week can be a pain, it must be the only way, right? Wrong! There are actually many TRT clinics available online. Instead of leaving home to see a doctor, you can reach a registered medical professional from the comfort of your own home. The one we have had the best results with is Fountain TRT. With decades of experience helping men achieve physical, mental, and sexual health again with high-quality TRT.
The process is actually quite simple. Fountain TRT uses a simple 3-step process with all their clients:
- Step #1: Take a free Low T assessment to see if you have symptoms of low testosterone. Your doctor will then schedule a time to talk to you about your results, and not even in person. This takes out the need to leave the comfort of your home, as the call will take place over Zoom.
- Step #2: Perform a blood test at one of their partnered labs to test your exact testosterone level. Your Fountain TRT doctor will coach you through this process, so it goes as smoothly as possible. Fountain TRT prides themselves on providing clear and helpful information every step of the way
- Step #3: Schedule a follow-up visit with your online doctor to discuss the results of your blood test. If you and your doctor agree that TRT is the right choice for you, then they will deliver your medication right to your door. Simple as that.
If you are looking for a great online TRT provider, then we highly recommend Fountain TRT. Here is where you can learn more about them:
Does Low Testosterone Cause ED? | Overall
Low testosterone levels can absolutely cause ED and other sexual problems. There is a large body of research showing that healthy testosterone levels are critical for achieving sexual arousal, as well as achieving and maintaining an erection.
Living a healthier lifestyle is the first step you can take to remedy the situation. However, if the situation at hand seems too severe, TRT will be a perfectly viable option for you to take. TRT is a safe and effective option for raising testosterone levels, as long as it is performed under the direction and guidance of a qualified healthcare practitioner.