The Truth About Erectile Dysfunction and Low Testosterone

Low testosterone is thought to be associated primarily with diminished sex drive – but most men don’t know the facts about erectile dysfunction and low testosterone. Watch this video explanation from MDVIP-affiliated physician Dr. Louis Minsky.


What are the symptoms of low testosterone?

LOUIS MINSKY, MD: Low testosterone symptoms are characterized by low stamina, loss of muscle mass, perhaps irritability, decreased sex drive and maybe erectile dysfunction as well.

FACT: According to the MDVIP/IPSOS Men’s Health Survey, 57% of men have never, or don’t know if they have ever, had their testosterone levels checked.

LOUIS MINSKY, MD: You should go see a doctor if you feel that you have low testosterone before you try supplements, or before you try some, uh, medical therapy that you think will intend to get your testosterone levels up. It generally takes a fasting blood test because sugar can lower testosterone levels. So you wanna have an adequate fast. You usually wanna draw that blood work between 8 and 10a AM in the morning. You wanna have those levels repeated on two or three occasions to validate that you truly do have low testosterone that's consistent and not waxing and waning. From there you can discuss with your physician whether testosterone replacement's necessary or whether there's some other lifestyle changes or natural ways that you can improve your testosterone level without having to begin medication.

Myth: More testosterone is better.

LOUIS MINSKY, MD: I know instances where men have had stroke or heart attacks after taking testosterone replacement therapy. And in every one of those cases, they were men who did not need testosterone replacement, but were hoping to have better testosterone levels so that they could perform better sexually. And that's just not very safe, uh, and should discuss with your doctor and know what your levels are before taking testosterone replacement therapy.

FACT: The proportion of men who have low testosterone increases from 0.1% in men aged 40 to 49 to 5.1% among those 70 to 79.

Myth: Erectile dysfunction is most often caused by low testosterone.

LOUIS MINSKY, MD: Cardiovascular disease and diabetes are both two very important disorders that affect erectile function. Both of those disorders can one, lead to low testosterone or two, arterial insufficiency or blood supply to the sex organ, so that it makes, uh, erectile ability weakened or non existent at all. It can be one of the earliest indicators in fact of heart disease.

Common Risk Factors for Erectile Dysfunction:

  • Type 2 diabetes
  • Hypertension
  • Cardiovascular disease
  • Chronic sleep disorder
  • Alcohol use
  • Depression
  • Smoking

LOUIS MINSKY, MD: Erectile dysfunction can come in a gentleman who's overweight, who's not eating very healthy, uh, glucose disorders, early diabetes, or prediabetes can lower testosterone levels that can somewhat lead to erectile dysfunction. Uh, obesity lowers testosterone. Uh, a gentleman is not very confident when they look in the mirror and see their body habitus. And so they, they don't want to go into the bedroom and perform. Uh, once erectile dysfunction has occurred once, twice or three times, it becomes more difficult to get that erectile function back, because now they're either embarrassed or they think something's really wrong, uh, and they just can't perform at the same way that they did previously.

Myth: Men with low testosterone usually need testosterone replacement therapy.

LOUIS MINSKY, MD: In the last decade, direct-to-consumer advertising has just flooded the airwaves in the media with advertising about low testosterone syndrome. As a result, three percent of American men are on some form of low testosterone replacement therapy, whether it's indicated or not indicated. When a gentleman experiences erectile dysfunction or what they consider to be low testosterone syndrome, an interview at the doctor, a physical examination and a stepwise approach to obtaining the right laboratory draw to determine if someone actually has low testosterone is very important.

FACT: High levels of testosterone can lead to:

  • High blood pressure
  • Headaches
  • Heart problems
  • Mood swings
  • Infertility
  • Weight gain

LOUIS MINSKY, MD: We discourage having trials of testosterone replacement therapy. If you have normal testosterone levels, you're not gonna benefit from increasing your levels of testosterone. And I think that the advertising and the media that we see give men the message that more is better. If I raise my testosterone levels above where they fall, then I'll be better sexually, or I'll be better strength wise, or I'll have more stamina. And that's just not been proven to be the case, especially if you truly do not have low testosterone.

Truth: Any form of exercise can increase a man’s testosterone levels.

LOUIS MINSKY, MD: There is a number of natural treatments for low testosterone. And low testosterone I'll define in this situation as maybe low normal or right at normal, or just below normal. We know that exercise will increase testosterone levels, weight loss by reducing body fat, eating Mediterranean or other plant-based type diets will lower sugar intake. And processed food decreased amounts of, uh, of, of processed foods also lower sugar, so that testosterone levels normally, uh, are elevated. Magnesium is found in peanuts, almonds and cashews. Oysters have large amounts of zinc. Pomegranate, fish, which has a lot of vitamin D. All of these are natural ways of increasing testosterone levels. And for someone who's borderline or just not that symptomatic, or maybe they don't want testosterone replacement therapy, these are some very natural ways that have been proven with good data to increase levels of testosterone.

FACT: For men, nearly any exercise will increase testosterone levels, according to multiple studies.

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