Does Low Testosterone Cause Erectile Dysfunction (ED)?

Low testosterone (Low T) occurs when testosterone levels fall below the normal physiologic range. Testosterone is a key hormone that influences sexual desire, erectile function, energy levels, mood, and overall metabolic health. When testosterone levels decline, many men experience a reduced sex drive and, in some cases, erectile dysfunction (ED)—the inability to achieve or maintain an erection sufficient for sexual activity (Basaria, 2014).

While low testosterone does not account for all cases of ED, it is a well-recognized contributing factor, particularly when accompanied by other chronic health conditions.

What Causes Erectile Dysfunction?

Erectile dysfunction is a multifactorial condition. In addition to low testosterone, common contributors include vascular, neurologic, metabolic, and psychological factors.

Common medical causes of ED include:

• High blood pressure

• Atherosclerosis (hardening of the arteries)

• High cholesterol

• Type 2 diabetes

• Obesity

Neurologic conditions such as multiple sclerosis, chronic back pain, spinal injury, and neuropathy can also impair erectile signaling. Psychological factors—including anxiety, depression, stress, and relationship issues—frequently play a role as well (Burnett et al., 2018).

How Does Low Testosterone Contribute to Erectile Dysfunction?

Testosterone is essential for normal erectile physiology, but the relationship between testosterone and erections is complex. Testosterone influences:

• Libido (sexual desire)

• Nitric oxide signaling in penile tissue

• Endothelial and vascular function

• Central nervous system sexual response

Some men with low testosterone may still achieve erections, while others experience significant ED. However, research clearly shows that low testosterone is strongly associated with chronic conditions that cause ED, including obesity, cardiovascular disease, insulin resistance, and type 2 diabetes (Corona et al., 2018).

In men with testosterone deficiency, restoring levels to a normal range can improve libido and erectile function—especially when low testosterone is a primary driver of symptoms.

Signs and Symptoms of Low Testosterone

Men with low testosterone often experience a constellation of symptoms beyond sexual dysfunction.

Common signs of Low T include:

• Diminished libido

• Erectile dysfunction

• Low energy or persistent fatigue

• Reduced sexual stamina

• Increased body fat, especially abdominal fat

• Difficulty focusing or concentrating

• Depressive symptoms

• Anxiety

• Thinning hair

• Irritability

(Bhasin et al., 2018)

If you are experiencing several of these symptoms, testosterone deficiency may be contributing to your concerns.

Can Testosterone Replacement Therapy (TRT) Help with Erectile Dysfunction?

TRT is most effective for ED when low testosterone is present.

• In men with normal testosterone levels, raising testosterone does not reliably improve erectile dysfunction. In these cases, ED is more likely due to vascular, neurologic, or psychological causes and should be addressed accordingly (Burnett et al., 2018).

• In men with documented testosterone deficiency, TRT can significantly improve libido and erectile quality and enhance response to other ED treatments (Corona et al., 2018).

Additional benefits of TRT may include:

• Improved mood and sense of well-being

• Increased bone density through improved calcium retention

• Reduced systemic inflammation and joint discomfort

• Increased lean muscle mass

• Higher energy levels

• Improved physical and mental stamina

• Enhanced concentration and memory

• Reduced insulin resistance

• Improved cardiometabolic health when appropriately monitored

(Basaria, 2014; Bhasin et al., 2018)

Think You May Have Low T? Take Our Assessment

If symptoms of low testosterone or ED are affecting your quality of life, identifying the root cause is essential. Our Male Testosterone Deficiency Assessment can help determine whether low testosterone may be contributing to your symptoms.

Take our assessment today or contact us with any questions—our team is here to help.

References

Basaria, S. (2014). Male hypogonadism. The Lancet, 383(9924), 1250–1263.
Bhasin, S., et al. (2018). Testosterone therapy in men with hypogonadism: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 103(5), 1715–1744.
Burnett, A. L., et al. (2018). Erectile dysfunction: AUA guideline. Journal of Urology, 200(3), 633–641.
Corona, G., et al. (2018). Testosterone and erectile dysfunction: From basic research to clinical practice. European Urology, 73(1), 33–44.