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What is the Role of Testosterone in Erectile Dysfunction (ED)?

What’s the role of testosterone in erectile dysfunction?

To discuss the role of testosterone in erectile dysfunction, it’s necessary to first take a look at what exactly testosterone is and what we mean by erectile dysfunction.

An erection is a complex function that depends on a variety of mechanisms. It’s initiated by a sexual stimulus, which can be of different types: visual, auditory, or an idea. It’s influenced by testosterone, a sex hormone.

Erectile dysfunction occurs when there’s a repeated inability to achieve an erection.

What is Testosterone?

Testosterone is a sex steroid hormone of the androgen (male) group. Androgens are very important for reproductive life as well as for general health and quality of life.

In particular, testosterone is produced mainly in the testes of men, although small amounts are secreted by the adrenal glands. It’s the main male sex hormone and is also an anabolic steroid.

Overall, testosterone has important functions:

  • The development of male reproductive tissues, such as the testes and the prostate.
  • The promotion of secondary sexual characteristics, such as body hair growth.
  • It regulates the neurological mechanisms of erection both centrally and peripherally.
  • Also, it regulates nitric oxide, a mediator that enables erection.
  • It controls both the initiation of erection (through activation of nitric oxide) and its termination.

Erectile Dysfunction

Erectile dysfunction is the permanent or temporary inability to achieve or maintain an erection firm enough to sustain satisfactory sexual intercourse.

Both biological and psychological mechanisms are involved in the mechanism of sexual desire. Therefore, there are many different things that can affect an erection:

  • Hormonal or bodily causes: Erectile dysfunction may be caused by an alteration of the vessels, nerves, or corpora cavernosa of the penis.
  • Psychogenic causes: The man’s psychological state can influence the development of erectile dysfunction. Psychogenic causes can include depression, problems at work, stress, etc.

It must be taken into account that, sometimes, both organic and psychogenic causes can occur in an individual. In this article, we’ll focus on physical causes, especially on the influence of testosterone in this phenomenon.

The physical causes of erectile disfunction

The most frequent physical causes are those that affect the blood vessels. This hinders the entry or maintenance of blood in the penis.

This can be caused by an injury, lesions in the arteries, or other obstructions (arteriosclerosis).

The penis is an organ that shares the risk factors for cardiovascular disease such as high cholesterol, smoking, diabetes, or obesity.

On the other hand, there are other causes for which erectile dysfunction can occur:

  • An illness or other injuries. For example, erectile dysfunction often occurs as a result of the complete removal of the prostate due to cancer. This is because the erectile nerves that are attached to the prostate can be injured.
  • Medications such as antihypertensives or antidepressants can affect an erection, as they act at different levels.
  • Drug use
  • Other toxic substances

The role of testosterone in erectile dysfunction

As we’ve already mentioned, testosterone is produced in the testes.

This production is influenced by the hormone LH (luteinizing hormone) produced in the adenohypophysis, a part of the pituitary gland in the brain. Therefore, altered testosterone concentration may be accompanied by altered sexual function.

Currently, however, there’s no firm evidence on the influence of testosterone on erectile function.

Studies conducted with subjects with severe hypogonadism suggest that the frequency of sexual activity, sexual desire, and spontaneous nocturnal erections are testosterone-dependent. Meanwhile, psychogenic erections, ejaculation, and orgasm are only partially dependent on testosterone.

Testosterone deficiency may be due to primary testicular failure, such as failure of testicular descent in infancy, chemotherapy, or testicular atrophy.

It may also be due to a deficit of hypothalamic-pituitary hormones. These hormones are produced in the hypothalamus and pituitary in the brain and have the function of stimulating or slowing down the production of this hormone.

On the other hand, a deficit of testosterone is often due to aging. This is very common and usually affects testosterone production both at the primary level and at the level of the hypothalamic-pituitary hormones. The consequences of the latter testosterone deficit are a decrease in the number of coitus and alterations in ejaculation and erectile dysfunction.

In general terms, testosterone deficit can cause:

  • Erectile dysfunction.
  • A decreased sex drive.
  • An increase in the size of the breasts.
  • A decreased sperm count.

Diagnosis of testosterone deficiency

For the diagnosis of testosterone deficiency, it’s necessary for doctors to perform a blood test. This test will includes readings of the:

  • Total and free testosterone.
  • Albumin and SHBG (globulin or sex hormone-binding protein).

In this way, a proper mathematical calculation of the amount of free or bioavailable testosterone, which is the one found in the blood and which causes activation, can be made.

The treatment of a testosterone deficit

One of the possible treatments for this deficiency is testosterone replacement therapy. This can be done through injections, patches, among other ways.

As with all therapies, there are risks that should be assessed by a specialist. If you have any questions, make sure to see a doctor.

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