HomeAnswersEndocrinologyerectile dysfunctionI have erection issues, and my testosterone level is 209.5 ng/dL. Please help.

Can low testosterone levels cause erection issues?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At March 18, 2023
Reviewed AtJune 19, 2023

Patient's Query

Hello doctor,

I am 28 years old and have no history of medical illness. I have erection issues and my testosterone level is 209.5 ng/dL. However, four years ago, I started having a depressed mood, fatigue, tiredness, increased weight, and body fat.

Please help.

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome to icliniq.com.

Your testosterone is low, but you must repeat the test, which should be done early morning and in a standard laboratory. You can do SHBG (sex hormone binding globulin), LH (luteinizing hormone), FSH (follicle stimulating hormone), and TSH (thyroid stimulating hormone), too.

1. How is your morning erection?

2. Are you taking any medication or any steroids?

3. Do you have any other issues?

Thank you.

Patient's Query

Hello doctor,

Thank you for your response.

The testosterone level was repeated, and both had the same result. TSH was normal, and I will try to do LH, FSH, and SHBG. Morning erection rarely happens, maybe once in 1 or 2 months, and not a good erection. I do not take any medication. Also, I do not have any issues other than this.

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome back to icliniq.com.

1. Are you married?

2. Do you have any fertility issues?

Let’s see the result of those tests, and we will discuss them accordingly.

Thank you.

Patient's Query

Hello doctor,

I am not married and do not have a family history of any fertility issues. I am attaching my laboratory reports (testosterone, free testosterone, LH, and prolactin).

Thank you.

Answered by Dr. Zulfiqar Ahmed

Hello,

Welcome back to icliniq.com.

Your testosterone and free testosterone is low. Other tests are normal. In my opinion, you can repeat it after two months, and if it's still low, we can start treatment with testosterone which is available in injection gels or patch form. In males, hypogonadism, a condition where the testicles produce little or no testosterone, may occur at any age.

Conditions that may cause hypogonadism include testicular injury or infection, chemotherapy or radiation cancer treatments, pituitary gland diseases or other hormone disorders, medications, such as corticosteroids and opiate pain relief, genetic conditions, such as Klinefelter syndrome, alcohol and drug abuse. You may be affected by primary, secondary, or mixed hypogonadism. Mixed hypogonadism is more common with increased age. People undergoing glucocorticoid therapy can develop the condition. It also can affect people with sickle-cell disease, thalassemia, or alcoholism. Excess weight, hair-loss treatments, and a sedentary lifestyle are among the factors that can lower testosterone levels. If you are concerned about low testosterone levels, look at your everyday habits and way of life. They could contribute to drop stress and can contribute to overall body dysfunction.

However, testosterone treatment has some risks, including erythrocytosis, gynecomastia, peripheral edema, exacerbation or de novo sleep apnea, acne, and mild weight gain. Testicular atrophy can occur more prominently in younger men. In addition, men must be advised that fertility will be impaired while receiving exogenous testosterone due to negative feedback on pituitary gonadotropins. Transdermal preparations are associated with local skin reactions in 3 % of men using gels and as many as 40 % of men using patches.

There is no evidence that testosterone supplementation represents a risk for cardiovascular disease; however, some studies suggest it may be beneficial. Although testosterone treatment may reduce high-density lipoprotein cholesterol, total cholesterol is also generally reduced, resulting in a net neutral effect. Liver toxicity is not associated with transdermal or intramuscular testosterone preparations. The greatest concern of clinicians regarding testosterone replacement therapy (TRT) is the possible stimulation of occult prostate cancer.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Zulfiqar Ahmed
Dr. Zulfiqar Ahmed

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