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Does Low Testosterone Cause ED (Erectile Dysfunction)?

Does low testosterone cause ED (erectile dysfunction)? The short answer is that, yes, it can, in some cases, but it’s more likely that something else is causing your erectile dysfunction, if it is severe, and that low testosterone is simply making a bad situation worse.

Does Low Testosterone Cause ED? Crumpled sheets in a dark room.

That being said, it’s often the case that ED and low testosterone (also known as hypogonadism) occur together, along with a host of other disorders and diseases. When this is the case, we often find that treatment of erectile dysfunction with drugs like viagra will be more effective when combined with low testosterone.

In fact, there are have been a variety of studies that show this to be the case. One study found that a form of testosterone helped restore sexual function in diabetic patients who weren’t responding to viagra.

Another study found that viagra, when given to men with diagnosed low testosterone and erectile dysfunction, was more effective when combined with testosterone than when given alone, especially in men who were found to be unresponsive to viagra alone.

So what’s going on here? Let’s dig in a bit.

Does Low Testosterone Cause ED? It Can, but Something Else Is Probably the Main Problem

The difficulty with this question is that so many different factors are at play.

Does low testosterone cause ED? Sure, it can by itself, but it’s more likely that you have a more prominent issue that’s causing the ED and that your low testosterone is only one of many factors affecting your ability to achieve and maintain a strong erection.

You see, testosterone only plays a small part in the erection process.

The main factor that you need to consider has much less to do with your hormones and much more to do with your blood flow.

To simplify a complicated process, an erection is achieved when your penis fills with blood. Your blood’s ability to flow through your body the way it should has a much more direct effect on your ability to have an erection and to maintain it, and it also has a much more direct effect on the strength of your erection.

So, it makes sense that diseases or disorders that affect blood pressure and blood flow are going cause erectile dysfunction. Here are a few diseases and disorders that may have a more powerful effect than low testosterone:

  • Obesity
  • Diabetes
  • Heart disease
  • Atherosclerosis
  • High blood pressure
  • High cholesterol

Now, if you combine these problems with clinically low testosterone, you’re probably going to have worse ED than you would otherwise.

Does Low Testosterone Cause ED? Here’s Where Things Get Complicated

For several of the diseases I listed above, low testosterone can be a severely complicating factor.

For the first two items on the list especially, low testosterone can be a significantly contributing factor to the severity of the disease.

Which means that low testosterone may be indirectly contributing to erectile dysfunction by worsening obesity and diabetes.

And it can get even more complicated as feedback loops are established: For instance, low testosterone can exacerbate obesity (and make weight loss harder), and the additional body fat can drive testosterone levels down even further, which can then turn around and drive the obesity… you see where this is going.

The obesity may then lead to high blood pressure or heart disease, which would then make the ED even worse…

So the problems begin to compound.

Low testosterone can also affect your libido (sexual desire), which further complicates your ability to achieve an erection.

As you can see, the truth is a lot more nuanced than it appears at first.

That’s why, when people ask me, “Does low testosterone cause ED?” I usually say, “Yes, but… it’s complicated.”

This May Be Why the Studies I Shared at the Beginning of the Article Found the Results That They Did

It may be that testosterone replacement therapy, combined with other treatments for ED (and even diet and exercise) may all combine to address a combination of problems.

So, to answer your original question (does low testosterone cause ED?), the answer is yes — but evaluation by a medical professional is critical to make sure that all contributing factors are addressed.

To learn more about our combination treatments for erectile dysfunction and low testosterone, click the button.

Learn More About Treatment for ED



(Augie) Juan Augustine Galindo Jr. MPAS, PA-C

(Augie) Juan Augustine Galindo Jr. MPAS, PA-C started his career in healthcare as a fireman/paramedic in West Texas where he served on the Midland Fire Department from 1998-2004.   He became interested in testosterone treatment after seeing how hormone replacement doctors helped those suffering from low testosterone.   After graduating from the Texas Tech Health Sciences Center Physician Assistant Program, he moved to DFW where he currently lives with his wife and three children.


  1. Giles McCrary on 06/29/2017 at 3:22 pm

    Before I started my therapy, I was concerned that my Cialis had seemly become ineffective. I was also having issues with orgasms. Several of the benefits of testosterone replacement therapy takes weeks and even months to materialize. (I’m in my tenth week, I believe.) However, one of the more immediate improvements for me was relief from my ever-worsening ED. After my first two treatments at the Hurst clinic, I noticed a drastic improvement not only with my ED, but also with achieving orgasms. I am very pleased and pleasantly surprised with this aspect of my therapy.

    • Augie Galindo on 07/03/2017 at 4:23 pm

      Mr. McCrary,

      Thank you very much for your feedback! We are happy to be working with you.

      Best regards,
      Augie Galindo MPAS, PA-C
      Testosterone Centers of Texas | Founding Partner

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