Testosterone and erectile function

[Rhino 2.0]

I was speaking with a doctor and he said testosterone has nothing to do with erectile function/ strength. He just said testosterone affects libido. Is he correct ? Would love to hear opinions.

 

[Nashtide]

I was speaking with a doctor and he said testosterone has nothing to do with erectile function/ strength. He just said testosterone affects libido. Is he correct ? Would love to hear opinions.

Erectile function is so multi factorial I don't think it's completely understood. I had super low T levels and had rock hard erections. I know have high T levels and my erections haven't changed. All sexual functions are extremely complicated.

 

[Vince Carter]

I tend to call it having the desire, or libido, to have sex. Be able, physically able (erection) is something else that I don't think Test is going to do though so multi faceted and complicated like Nashtide says.

 

[S1W]

We're all different of course, but my experience was that testosterone had a definite, positive impact on erectile function.

 

[S1W]

I think ED is usually psychological.

In many cases of ED I'd say you're right. But in my case, I injured my dong during sex. Erections became inconsistent and painful basically overnight. I lived with this for a bit - it was challenging to say the least - hoping it would just heal up and go away. It didn't.

TRT, and I believe most importantly the nocturnal erections that came along with it, effectively healed me.

 

[madman]

I was speaking with a doctor and he said testosterone has nothing to do with erectile function/ strength. He just said testosterone affects libido. Is he correct ? Would love to hear opinions.

Key points

■ Testosterone levels can reflect perturbations in all three dimensions (organic, intrapsychic and relationship) of erectile dysfunction (ED)

■ Testosterone is important not only in controlling the mechanical process of penile erection, but it also controls male sexual behavior and attitudes

■ Testosterone replacement therapy (TrT) should be considered the first-line treatment in hypogonadal patients with ED

■ TrT monotherapy might not be adequate in all cases of ED because of the multifactorial pathophysiology of this disorder

■ In these cases, combination therapy with phosphodiesterase 5 inhibitors might improve outcomes indirectly, several of the mechanisms that lead to erection and detumescence

 

[Tommy Wall]

For me it makes me think more of sex than really doing it but I´m 57 years old. However it comes with a side effect atleast for me that my penil sensitivity is not as good as before TRT treatment.

 

[broker]

It definitely increases libido. Most men cannot get an erection because their libido is low and they only initiate sex because they think they have to, not because they want to. The penis also has androgen receptors in which Testosterone helps.

 

[Vince]

Effect of androgens on penile tissue.
There are two ways to establish that androgens play a major role in the function and integrity of erectile tissue: (1) discussing a number of physiology and molecular biology studies that have been published from experiments in animals and (2) reporting the effect of androgens on penile tissue, or in many cases the lack of androgen, in man.
Effect of androgens on penile tissue. - PubMed - NCBI

 

[Vince Carter]

Id like to know more about E affecting blood flow or penile tissues that can contribute to ED and related problems, I think Ive read that just once but it's not talked about much.

 

[Systemlord]

Id like to know more about E affecting blood flow or penile tissues that can contribute to ED and related problems, I think Ive read that just once but it's not talked about much.

I'm interested as well in how E2 effects erections. My set point for estrogen must be on the lower end do to me having limited erections when E2 was 12. A lot of men have limited or no erections at all below 20.

 

[Nelson Vergel]

I was speaking with a doctor and he said testosterone has nothing to do with erectile function/ strength. He just said testosterone affects libido. Is he correct ? Would love to hear opinions.

More convincing data does exist for younger men than older men with low T and those with "milder" type of ED. Data is stronger for libido in both populations, though.


Eur Urol. 2017 Dec;72(6):1000-1011. Epub 2017 Apr 20.
Meta-analysis of Results of Testosterone Therapy on Sexual Function Based on International Index of Erectile Function Scores.
Corona G1, Rastrelli G2, Morgentaler A3, Sforza A1, Mannucci E4, Maggi M5.


Abstract

CONTEXT:
The interpretation of available clinical evidence related to the effect of testosterone (T) treatment (TTh) on sexual function has been inconsistent, in part due to the use of different and self-reported measures to assess outcomes. The International Index of Erectile Function (IIEF) is the most frequently used validated tool to assess male sexual function.

OBJECTIVE:
To perform a meta-analysis of available data evaluating the effect of TTh on male sexual function using IIEF as the primary outcome.

EVIDENCE ACQUISITION:
An extensive Medline, Embase, and Cochrane search was performed including all placebo-controlled randomized clinical trials enrolling men comparing the effect of TTh on sexual function.

EVIDENCE SYNTHESIS:
Out of 137 retrieved articles, 14 were included in the study enrolling 2298 participants, with a mean follow-up of 40.1 wk and mean age of 60.2±6.5 yr. Using IIEF-erectile function domain (IIEF-EFD) as the outcome, we found that TTh significantly improved erectile function compared with placebo (mean difference=2.31 [1.41;3.22] IIEF-EFD score, p<0.0001). Patients with more severe hypogonadism (total T<8 nmol/l) reported greater changes in final IIEF-EFD score when compared with those with a milder T deficiency (total T<12 nmol/l; 1.47 [0.90;2.03] and 2.95 [1.86;4.03] for total T<12 nmol/l and <8 nmol/l, respectively, Q=5.61, p=0.02). The magnitude of the effect was lower in the presence of metabolic derangements, such as diabetes and obesity. Other aspects of sexual function, as evaluated by IIEF subdomains, were also improved with TTh including libido, intercourse satisfaction, orgasm, and overall sexual satisfaction.

CONCLUSIONS:
TTh significantly improves erectile function and other sexual parameters as measured by IIEF in hypogonadal men. These results argue that sexual dysfunction should be considered a hallmark manifestation of T deficiency, since those symptoms can be significantly improved with normalization of serum T. In addition, these results suggest that TTh alone may be considered a reasonable treatment for hypogonadal men with milder degrees of erectile dysfunction, whereas the addition of other treatments, such as phosphodiesterase type 5 inhibitors, may be more appropriate for men with more severe erectile dysfunction.

PATIENT SUMMARY:
We investigated the effect of testosterone treatment on sexual function by performing a meta-analysis of all available studies that used the most frequently used assessment tool, the International Index of Erectile Function. We found that testosterone treatment significantly improves erectile dysfunction, as well as other aspects of sexual function, in men with testosterone deficiency. This treatment may be all that is required for hypogonadal men with milder erectile dysfunction; however, additional treatments may be necessary in more severe cases.

 

[joshmaximus]

Erectile function is so multi factorial I don't think it's completely understood. I had super low T levels and had rock hard erections. I know have high T levels and my erections haven't changed. All sexual functions are extremely complicated.

Where is your e2 level at?

 

[Montrealer]

We're all different of course, but my experience was that testosterone had a definite, positive impact on erectile function.

It was my experience too.

 

[T-dog]

I can almost assure you that my Estradiol levels MUST be in range in order to function properly. Days following the times I haven't taken my estrogen-blocker properly are not great performance days for me. Takes me about a week to get back to "normal". And sometimes when I may have taken a second pill because I wasn't sure I took the first one, I may experience even better performance. I'm not sure how testosterone affects it, because I've been very consistent with that and haven't missed much of my protocol.

I also always like to mention it's been a few years now, and I'm still noticing increased sexual recovery. Still nowhere close to what it used to be (which only after missing it do I realize was exceptional) but it wasn't like I hit a year or 18 months and my recovery leveled off. So the benefits of TRT are still making themselves felt.

 

[Nashtide]

Where is your e2 level at?

As of July 25th it was 25 and that's the sensitive E2 test. Since then, I dropped the anastrazole based on comments from some of the guys on this site. I am scheduled to retest on October 17th. I'm sure it will be up a little. I feel great and no noticeable difference in erection quality or anything else.