If you have low T, your levels of the male sex hormone, testosterone, drop below normal. When that happens it may affect your sex life. Your sex drive could go down. And you might develop erectile dysfunction (ED).
Men with ED have trouble getting or maintaining an erection suitable for sex.
ED Has Many Causes
It's important to remember that low T isn't the only cause of ED.
The most common cause of ED is reduced blood flow to the penis due to chronic conditions such as high blood pressure, high cholesterol, and hardening of the arteries.
Psychological problems such as depression, anxiety, and relationship issues are also possible causes of ED. So are multiple sclerosis, spinal cord injuries, chronic back pain, and other neurological conditions.
The Link Between Low T and ED
Erections depend on testosterone, but the relationship between the two is complex and not fully understood. Some men have healthy erections despite testosterone levels well below the normal range.
What is clear is that low testosterone levels are linked to a number of the same chronic conditions that play a role in erectile dysfunction, such as type 2 diabetes, obesity, and heart disease.
Testosterone Replacement Therapy and ED
If your testosterone level measures in the normal range, raising it through testosterone replacement therapy (TRT) probably won't help your ED. Instead, you'll have to look for and address other causes.
For men who do have low testosterone levels, TRT has a better track record of restoring a man's sex drive than overcoming ED.
While many men on TRT do report improvements in their erections, they often need added help from ED drugs known as PDE-5 inhibitors, such as:
These drugs encourage erections by increasing blood flow to the penis. Some men with low T, on the other hand, don't respond to these drugs without also undergoing TRT.
Some research suggests that erection improvements that result from TRT may not last over the long term.
Treating low testosterone can improve a man's sex life by restoring their libido and brightening their mood, thereby renewing their interest in sex.
In men with low testosterone, TRT may also protect against some of the risk factors for ED by reducing belly fat, increasing insulin sensitivity, and lowering the risk for diabetes.
Some studies suggest that TRT in men with low T may benefit heart health, although in high doses it can make heart disease worse.
TRT does have risks and side effects, though, and its long-term safety and effectiveness have not been thoroughly studied.
Some of the side effects of TRT include:
Check with your doctor for other possible side effects.
If you have low testosterone and ED, your doctor may prescribe a trial of TRT to see whether boosting your testosterone levels will also boost the quality of your erections and improve other symptoms of low T.
In addition to treatment for low T, regular exercise and a healthy diet also can contribute to a rise in your testosterone levels, especially if you're overweight or obese. Both can also improve libido and ED.