Does Low Testosterone Cause ED?

Written on August 1, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• What Is ED?
• What Is Low Testosterone?
• Does Low Testosterone Cause ED?
• More on Causes of ED
• ED Diagnosis and Treatment
• Telehealth Testing With Everlywell
• Related Content

It can be hard to discuss your sexual health. In men, testosterone levels can impact sex drive.[1] Low testosterone levels and other medical conditions that decrease testosterone, such as depression, have been connected to a loss of sex drive. But does low testosterone cause ED? Keep reading to learn more about the link between ED and low testosterone.

What Is ED?

ED, or erectile dysfunction, is a disorder where you are not able to get or keep a penile erection firm enough for adequate sexual intercourse.[2] Erectile dysfunction is very common in men. One estimate reports more than 18 million American men, or around 18% of the male population aged 20 years or older, are affected by ED.[3] Another estimate states that approximately 30 million men in the United States have ED.[2] Erectile dysfunction is more likely to occur if you are older, have certain diseases, take specific medications, have psychological or emotional issues, or have health-related factors such as being overweight.[4]

What Is Low Testosterone?

Low testosterone in men is referred to as male hypogonadism.[5] Other names for low testosterone include testosterone deficiency syndrome, primary or secondary hypogonadism, or hyper or hypogonadotropic hypogonadism. Testosterone is the male sex hormone. Low testosterone is a condition where not enough testosterone is produced by the testicles. The two leading causes of low testosterone are primary and secondary hypogonadism. Primary hypogonadism occurs because there is a testicular disorder. Secondary hypogonadism happens when there is pituitary or hypothalamus dysfunction.

Symptoms of low testosterone in adult men may include [5]:

• Reduction in sex drive
• Erectile dysfunction
• Loss of hair in the armpit and pubic area
• Shrinking testicles
• Hot flashes
• Low sperm counts

Does Low Testosterone Cause ED?

A symptom of low testosterone is erectile dysfunction.[5] But does that mean that low testosterone causes ED? Not necessarily. Having low testosterone does not always cause ED.[6] Sexual dysfunction, severe ED, and loss of spontaneous erections are found to be only weakly related to low testosterone.[7] The relationship between low testosterone and ED is more complex. Endocrine system disorders, such as low testosterone, are an uncommon cause of ED.[8] About 20% of middle-aged men and older complained of sexual dysfunction and have low testosterone.[7] Around 1 in 3 men who have ED can also have low testosterone.[9] While low testosterone can impact erectile function, conditions that are more likely to cause ED are vascular disease and diabetes.[9,10]

More on Causes of ED

Low testosterone is not a clear cause of ED. Factors more commonly associated with causing ED include [2]:

• Certain diseases and conditions, including type 2 diabetes, heart and blood vessel conditions, atherosclerosis, high blood pressure, and chronic kidney disease
• Taking specific medications such as blood pressure medications, antidepressants, ulcer medicines, and appetite suppressants
• Some psychological and emotional issues like depression, anxiety, and stress
• Health-related factors and behaviors such as smoking, a sedentary lifestyle, being overweight, and excess alcohol use

ED Diagnosis and Treatment

ED is diagnosed by taking a medical and sexual history and conducting a mental health and physical exam.[2] Your healthcare provider may also order different lab testing to assist in the diagnosis and uncover underlying causes of ED like diabetes, chronic kidney disease, and hormonal issues. ED can be treated with lifestyle changes, including quitting smoking, limiting drinking alcohol, and increasing physical activity. Your healthcare provider can also suggest counseling to help address the psychological or emotional issues impacting your ED. If you are taking a medication known to cause ED, your healthcare provider may suggest changes. You can also get a prescription medicine that can be taken by mouth to treat ED. Another option may include taking testosterone to help improve ED.

Telehealth Testing With Everlywell

If you have some of the symptoms of ED or low testosterone, you may want to speak with a healthcare provider. Via the Everlywell telehealth option, you can schedule a men's health support visit to discuss your concerns and potentially get a care plan which may include testing, prescriptions, or lifestyle recommendations.

You can also select to complete a total testosterone test with sample collection at home (and sample testing at a lab). This test helps to measure your total testosterone level. Your results will provide in-depth information on whether your total testosterone level is normal, low, or high. You may receive lifestyle tips to support healthy testosterone levels and overall wellness based on your results. The information and your test result can help you and your healthcare provider address any testosterone-related symptoms you may be experiencing.

Related Content

Is Testosterone a Steroid?

Does Working Out Increase Testosterone?

Does a Vasectomy Lower Testosterone?

References

1. Loss of sex drive in men: Natural with aging? Mayo Clinic. April 19, 2022. https://www.mayoclinic.org/healthy-lifestyle/sexual-health/expert-answers/loss-of-sex-drive/faq-20058237. Accessed July 25, 2023.
2. Erectile dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction. Accessed July 25, 2023.
3. Selvin E, Burnett AL, Platz EA. Prevalence and risk factors for erectile dysfunction in the US. Am J Med. 2007;120(2):151-7. doi: 10.1016/j.amjmed.2006.06.010
4. Definition & Facts for erectile dysfunction. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts. Accessed July 25, 2023.
5. Low testosterone: Causes, symptoms & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadism. Accessed July 25, 2023.
6. Diabetes and men. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes-and-men.html. Last Reviewed March 15, 2022. Accessed July 25, 2023.
7. Corona G, Maggi M. The role of testosterone in male sexual function. Rev Endocr Metab Disord. 2022;23(6):1159-1172. doi: 10.1007/s11154-022-09748-3
8. Rajfer J. Relationship between testosterone and erectile dysfunction. Rev Urol. 2000;2(2):122-8.
9. Does low testosterone cause erectile dysfunction? Cleveland Clinic. https://health.clevelandclinic.org/low-testosterone-and-ed/. March 16, 2023. Accessed July 25, 2023.
10. Sooriyamoorthy T, Leslie SW. Erectile Dysfunction. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK562253/.