Does Low Testosterone Cause ED?

Does low testosterone cause erectile dysfunction (ED)? The short answer: Not directly. But this doesn’t mean there isn’t any correlation at all.

It turns out that normal testosterone levels — 300 to 1,000 ng/dL (nanograms per deciliter) — strongly correlate to sexual desire, and desire is a key player in increasing blood flow to your penis.

But get this: Low testosterone levels (sometimes called low T or hypogonadism) could decrease sexual desire, making it hard to get erect and potentially causing ED issues.

While testosterone definitely plays a role in sexual function, many men with low levels of testosterone can get erections just fine. On the other hand, guys with healthy testosterone levels might find it hard to get and maintain an erection during sex.

So… What’s the deal here? 

Below, we’ll discuss testosterone’s role in male sexual health and performance, as well as the effects low T may have on your sex life. We’ll also list other common symptoms of low testosterone levels and steps you can take to increase testosterone.

Let’s get into it!

Though researchers still don’t fully understand the precise relationship between testosterone and erectile dysfunction, they generally agree on two things:

• First, you don’t need to have normal testosterone levels to get or keep an erection during sex. 

• Second, beyond a certain point, higher testosterone levels don’t appear to lead to stronger, more frequent or more reliable erections. 

Can low testosterone cause ED? Testosterone definitely plays a role in overall sexual function, but saying it’s a direct cause wouldn’t be entirely accurate.

Hormones like testosterone are important for healthy sexual desire. That said, erectile dysfunction is primarily a vascular issue — not a hormonal one.

An erection is the result of a whole bunch of factors like sexual stimulation, sexual desire and blood flow to the tissue of the penis. In other words, it’s a group effort from the brain, body systems and external stimuli.

Low testosterone levels may affect sexual arousal — an issue that might be linked to ED if you feel little or no desire for sex. However, they don’t appear to be responsible for any changes in blood flow to the penis.

Although low testosterone doesn’t necessarily cause erectile dysfunction, many potential contributing factors for the two conditions overlap.

For example, low testosterone is associated with medical conditions such as:

• Obesity

• High blood pressure (hypertension)

• Heart disease

• Type 2 diabetes

These are also common risk factors for erectile dysfunction that can compromise blood flow to the penis and affect sexual performance. 

Like erectile function, T levels can drop temporarily due to too much exercise, poor nutrition, severe illness and certain medications. Low testosterone may also affect sex drive and mood, which could be contributing factors to ED, too.

If you have any of these risk factors and also have ED, consider talking to your healthcare provider about checking your testosterone levels. Although low testosterone likely isn’t to blame for most men with erectile dysfunction, it can cause a wide range of symptoms.

Some symptoms of low testosterone can have a major negative impact on sexual health and quality of life.

Common signs of low testosterone include:

• Reduced sex drive

• Erectile dysfunction

• Small testes

• Delayed or incomplete sexual development

• Loss of body hair

• Reduced beard growth

• Subfertility

• Reduced bone mass

• Increased body fat

• Decreased energy and motivation

• Depressed mood

• Loss of concentration

If you have low testosterone, you might develop one or several of these symptoms. 

The more signs you notice, the more critical it is to get your testosterone levels checked for a potential deficiency.

If you think low T is causing your ED, you have options. From lifestyle tweaks to medications, we’ll cover how to increase testosterone and help reverse ED.

Get Your Testosterone Levels Checked

Suspect you have low testosterone levels? Get them checked.

That’s really the best place to start. A medical professional may recommend getting your T levels checked if you show signs of early or late puberty (in younger boys) or symptoms like infertility, ED, low sexual interest and thinning bones (in men).

The best way to test testosterone levels is through a blood test, and in some cases, you might need to do it twice to confirm the results.

A normal range for early-morning testosterone for men is between 300 to 1,000 ng/dL, so low testosterone is diagnosed when it’s less than 300 ng/dL. Elderly men typically want to aim for testosterone levels between 500 and 800 ng/dL, and for young adults, it should be 600 to 900 ng/dL.

Keep in mind that even if your levels are normal on a blood test, you could still experience persistent signs of low T levels. Your medical provider may need to make their own judgment when diagnosing you.

Exercise Regularly and Consume a Healthy Diet

It might be a bit of cliche, but getting exercise and eating healthy can do wonders for all sorts of things.

Turns out, there are some seriously strong correlations between ED and obesity, as well as depression (which exercise and diet can really help with). In fact, one-third of diabetic men have low testosterone. 

In a 2019 study of nearly 4,000 men with sexual dysfunction, diabetes and other chronic illnesses were associated with testosterone deficiency. Given that many metabolic diseases can be avoided through diet and exercise, it makes sense to stay active and eat healthy to preserve sexual function.

Consider peppering in more exercise, like daily walks, a quick yoga video or weekly visits to the gym. Adding a few more fruits, vegetables and whole grains to your diet could be helpful, too.

Chat with a medical provider before making any drastic changes to your diet and exercise routine, and ask how testosterone and ED may be affected. 

Maintain a Healthy Weight

Making healthier food choices and getting your body moving can help you maintain a healthy weight. As mentioned above, chronic diseases like diabetes and obesity are associated with lower T levels and ED.

According to a 2019 review of research on younger males, low testosterone levels may be caused by underlying conditions that, if remedied, can improve T levels and sexual function. It also suggested that weight loss can increase testosterone levels in men.

A 2014 review found that low testosterone levels are quite common in obese men because insulin resistance can reduce certain sex hormones. If low T levels are a result of obesity, they can be reversed — but it may require substantial weight loss.

Reduce Your Stress Levels

High stress levels can wreak havoc on all sorts of body processes, from sleep and pain to sexual performance anxiety. Stress is kind of unavoidable and can be amplified (or even caused) by anxiety and depression, two psychological ED factors.

Mental health issues aside, severe stress could lead to unhealthy coping mechanisms like substance abuse. Abusing drugs or alcohol has plenty of downsides, but the substance abuse itself can actually lead to low testosterone and erectile dysfunction.

According to a 2019 review, there’s been a progressive deterioration of male sexual function in Western countries over the past 50 years. Unhealthy lifestyles — like those associated with substance and drug abuse — can cause a decline in testosterone levels and sperm production.

Stress-relieving techniques like meditation, exercise or talking to a mental health professional could be helpful.

Improve Your Sleep Habits

Sleep and stress are also closely connected. Lack of shut-eye could lead to various physical and mental health issues that could, in turn, affect T levels and possibly contribute to ED.

According to the CDC (Centers for Disease Control and Prevention), adults should be getting seven or more hours of sleep a night.

A 2011 study looked at 10 healthy older men to see how one week of sleep restriction to five hours per night affected their testosterone levels. It showed that daytime testosterone levels decreased by 10 to 15 percent.

At least 15 percent of the U.S. working population is only getting five hours of sleep a night regularly. Not so good for the testosterone levels of men, it seems.

Keep in mind, though, that this study was quite small and may not be statistically significant. Still, getting enough sleep will do you good on many levels.

Use Testosterone-Boosting Foods and Supplements

Eating healthy: important. Eating foods that boost testosterone: even better.

Ain’t no harm in adopting a diet that’s also a testosterone booster (that is, of course, if you’re not allergic or sensitive to any of these foods). T-level-boosting supplements could help, too.

Some foods may boost testosterone by curbing the body’s natural process of converting the male hormone into estrogen.

A 2021 review looked at which foods, extracts and supplements pulled this off best. Some include:

• Ginseng

• Red wine (cabernet sauvignon seems to be best)

• Grape seed extract

• White button mushrooms

• Red clover flower

• Mangosteen extract

• Extract from saw palmetto

• Collard green extract

• Tomato leaves

• Green tea

• Chamomile tea

• Coffee

• Cocoa

• Kale

• Potato

• Parsley 

• Celery

The review also mentions that boron, an element found in various foods, may increase concentrations of testosterone. Foods containing large amounts of boron include:

• Fruit

• Milk

• Beans

• Potatoes

• Tubers

• Legumes

• Coffee

• Cider

• Wine

• Beer

Use ED Treatments

Will testosterone help with ED if you boost it the natural way? It’s hard to say.

In some cases, you might want to seek reinforcements through pharmaceutical treatments, particularly the PDE5 inhibitors, which help increase blood flow to the penis. 

PDE5-inhibiting ED treatments include: 

• Sildenafil. Sildenafil is both the active ingredient and generic form of Viagra®. It provides relief from ED for around four hours per dose.

• Tadalafil. Tadalafil is the active ingredient and generic version of Cialis®. It’s a longer-lasting ED medication that can work for up to 36 hours per dose.

• Stendra®. Also sold as generic avanafil, Stendra® is a second-generation ED medication that’s fast to work and less likely to cause certain side effects associated with other ED drugs.

Don’t love taking oral medications? Consider chewable ED hard mints.

Another treatment option is testosterone replacement therapy, which involves taking prescription testosterone in the form of an injection, patch or gel.

Low testosterone doesn’t exactly cause ED — but there’s significant overlap between medical and mental health conditions that can contribute to both ED and low T levels.

By changing up your lifestyle habits, treating underlying health conditions and considering ED medication, you can boost testosterone levels.

Here’s what to remember:

• As you age, your testosterone levels naturally decrease, and erectile dysfunction is more likely to occur.

• ED and Low T may or may not be a sign of an underlying condition.

• Excess weight, lack of sleep, high stress levels and conditions like diabetes and obesity are common causes that can lead to lower testosterone levels.

• Online therapy could help you manage mental health concerns like stress, anxiety and depression, which may contribute to ED. Lifestyle changes can make a big difference, too.

• Erectile dysfunction medications include PDE5 inhibitors like Viagra®, Cialis® and Stendra®. Testosterone therapy is another treatment option.

• It’s vital to discuss any changes in sexual functioning with your healthcare provider to figure out the root cause(s) and see what treatment options are available.

Want to learn more about erectile dysfunction? Check out the pros and cons of the best ED drugs, and find out how stress can cause sexual dysfunction.