Most men find that their sexual desire increases after they start testosterone replacement. Sexual dreams and nighttime/morning erections may be more easily achievable, but in some cases, testosterone alone does not make erections strong or lasting enough for successful intercourse. So, some men need some extra help to make sure that their improved sex drive matches an improved and hard erection.
Before we start covering other options for improving erections, let’s talk about steps you should take before you start combination therapy of testosterone plus other options. If erectile dysfunction or sex drive is not improved while on testosterone, ask your doctor about adjusting your dose of testosterone. Ensure that your total testosterone level is between 500 and 1000 ng/dL. Low levels of thyroid hormone, infections, lack of sleep, alcohol, smoking, medications, and depression also can cause erectile dysfunction in the presence of normal testosterone levels. Blood pressure medications are known to be one of the main causes of erectile dysfunction, so discuss the different types of medications to keep your blood pressure in normal ranges (high blood pressure is also a risk factor for erectile dysfunction). Last but not least, a lack of attraction for our sexual partner can get in the way of achieving a strong erection.