Historically, low testosterone in men was commonly blamed for the inability to achieve and sustain an erection and hormone replacement therapy was considered the fix. Today, however, significant progress has been made in diagnosing the causes of erectile dysfunction (ED) and targeting the right treatment method for individual men.
The hormone testosterone is responsible for the development and maintenance of male reproductive tissues and typical male characteristics. "Testosterone and manliness are linked in our minds," Dr. J. Francois Eid says, "and so many men with ED issues quickly blame their testosterone level." Eid is a world renowned urologist who specializes in ED treatment, penile implants and penile prosthesis surgery with his innovative "No Touch Surgical Technique." He is Clinical Associate Professor of Urology at the Weill -Cornell Medical College of Cornell University and Director of Advanced Urological Care, PC in Manhattan, NY.
Problematically, many doctors make the same mistake and set men with erectile dysfunction on a course of androgen replacement therapy that can actually do a disservice to the patient. Aggressive marketing and pressure from the pharmaceutical industry further exacerbate the dangerous practice of hormone replacement therapy. Some of the long-term effects of replacing a man's testosterone level are known, though Dr. Eid believes the risks of long-term usage could be more severe than we realize today.
Testosterone replacement brings a range of negative side effects including:
- Complete suppression of natural testosterone production
- Reduced sperm production that can ultimately lead to infertility
- Shrinking of the testicles
- Permanent testosterone dependence
- Increased risk of fluid retention, blood clots, stroke, and liver problems
- Increased difficulty with urination
- Promotes growth of prostate tissue
- Promotes growth of prostate cancer
- Breast enlargement
Unfortunately, many men mistake improved mood and increased energy as evidence of testosterone's effectiveness. In reality, these changes are only brought on because testosterone is a steroid. When patients stop testosterone replacement therapy they can experience severe depression and withdrawal, in addition the inability to produce testosterone naturally.
"Testosterone is an important sex hormone, but there is no strong correlation between low testosterone levels and erectile dysfunction," explains Dr. Eid, "A man's testosterone level affects his sexual desire, but it does not impact his ability to have an erection." Many studies have shown that testosterone replacement has failed to benefit erectile function in men with normal or borderline low testosterone. Left untreated, erectile dysfunction can create a negative cycle whereby reduced incidence of erections leads to reduced sexual desire, which can be misinterpreted as low testosterone.