Testosterone is a hormone responsible for male sexual development as well as sexual desire in all genders. If your body is not producing the expected level of testosterone, you may experience a number of symptoms, including weight gain and decreased libido. Testosterone may play a role in erectile dysfunction, or the ability to achieve and maintain an erection.

Keep reading to find out how testosterone could affect your erectile dysfunction and solutions to treat low testosterone and erectile dysfunction.

Low testosterone can cause physical, mental, and sexual symptoms. Examples of Symptoms Related to Sexuality low testosterone levels can cause:

  • decrease in sexual desire
  • fewer sex-related erections
  • fewer spontaneous erections (like when you wake up with an erection)

Researchers have found that sexual fantasies and even daydreaming can be affected by your testosterone levels. A lack of testosterone can then affect your ability to masturbate, as you may not be able to generate the sexual fantasies or desire to do so.

Testosterone also influences erections at two levels in your body. The first is in your central nervous system (CNS). Testosterone can stimulate your central nervous system to release neurotransmitters, or chemical messengers to your brain that are responsible for helping you achieve an erection, including dopamine, nitric oxide, and oxytocin.

The second level involves stimulating your spinal nerves to cause changes in blood vessels that help you achieve and maintain an erection.

Testosterone plays a role in sexual desire and in getting and maintaining an erection. But this is not the only factor that goes into sexual activity. Your testosterone levels and their effect on your ED also appear to have a dose-dependent relationship. This means that unless your testosterone levels are very low, you probably won’t see many sexual changes related to low testosterone.

But it is important to know that people with low testosterone also often have other chronic health conditions, including heart disease, high blood pressure and diabetes mellitus. These disorders can contribute to erectile dysfunction because they affect blood flow and sensation. But chronic medical conditions generally do not affect your sex drive as much as having low testosterone.

High levels of testosterone are generally not known to cause erectile dysfunction. If you have naturally high testosterone levels and are having erectile difficulties, you should talk to a doctor or healthcare professional as it is likely due to another issue.

But those who take testosterone illicitly (for example to boost bodybuilding) can also suffer from erectile dysfunction and many other symptoms. Although it may seem like more is always better when it comes to testosterone, in reality excess testosterone in your body is converted into estrogen (regardless of your gender). This increase in estrogen may further contribute to erectile dysfunction.

If you have low testosterone and erectile dysfunction, you may benefit from testosterone therapy as well as taking phosphodiesterase inhibitors. Using this approach is more likely to effectively treat erectile dysfunction than taking phosphodiesterase inhibitors alone.

But taking testosterone replacement therapy alone isn’t likely to treat erectile dysfunction, according to the American Urological Association. This is likely because erectile dysfunction can have many underlying causes. Treating these causes as well as low testosterone can bring improvements to your sexual health and overall health.

HRT and erectile dysfunction

Some transgender people who were assigned male at birth may wish to undergo hormone therapy as part of their medical transition. When this is the case, a doctor can prescribe hormone replacement therapy (HRT) in the form of estrogen and gonadotropin-releasing hormone to increase estrogen and decrease testosterone. The results can be a more “feminine” appearance, including breast growth.

Another side effect of HRT can be fewer erections and decreased libido. If this happens to you and you want to support your erectile function, talk to a doctor. They go usually prescribe medications used to treat erectile dysfunctionsuch as phosphodiesterase inhibitors like sildenafil (Viagra) or tadalafil (Cialis).

ED can have many contributing factors. As a result, a doctor can recommend several strategies to treat it. Examples include:

  • medicines to improve blood flow to your penis, such as sildenafil (Viagra), tadalafil (Adcirca and Cialis), vardenafil (Levtra and Staxyn), and avanafil (Stendra)
  • testosterone replacement
  • injections of the drug alprostadil (Caverject and Edex) to improve your erections
  • using penis pumps or vacuum erection devices
  • use penile implants
  • participate in counseling to help reduce stress, anxiety or depression, which can contribute to erectile dysfunction

It’s important to talk to a doctor about your treatment options to regain your sexual function and enjoy a healthy sex life at any age.

Low testosterone can be one of many contributing factors to erectile dysfunction. If you have trouble getting or keeping erections or have other symptoms of low testosterone, talk to a doctor.

A doctor can perform blood tests or other tests to determine potential causes of your erectile dysfunction and recommend a treatment that is right for you.