Last updated on December 9, 2025
Erectile dysfunction (ED) and low testosterone are two of the most common issues affecting men’s sexual health. Both can impact confidence, energy and overall wellbeing, but are they the same problem and more importantly, can low testosterone cause ED? Erectile dysfunction is very common. In fact, a UK-based real-world study found that 41.5% of men reported some degree of ED. While ED can arise from many causes, hormonal imbalance is a key factor for a substantial subset of men.
At MansMatters, we focus on identifying the root cause of performance issues through comprehensive assessment and evidence-based treatment. Understanding the link between testosterone levels and erectile function is the first step to effective care.
The Role of Testosterone in Sexual Function
Testosterone plays a central role in male health. It regulates libido, supports muscle mass and influences mood, energy and endurance. While it contributes to sexual function, it doesn’t directly control the physical mechanism of erection; that process relies heavily on blood flow, nerve function and nitric oxide signalling within penile tissue.
When testosterone levels fall below normal, men may notice changes in sexual desire, stamina and mood. These shifts can contribute to erectile difficulties, but the hormone alone is rarely the single cause.
Can Low Testosterone Cause ED?
The short answer is that low testosterone can contribute to erectile dysfunction, but it is not usually the sole reason. Research shows that men with clinically low testosterone (hypogonadism) often experience a reduction in sexual desire and may find it harder to achieve or maintain an erection. However, vascular, metabolic and psychological factors are often involved too.
Low testosterone primarily affects libido, the mental drive for sexual activity. When desire decreases, erections may become less frequent or more difficult to sustain, which can be mistaken for ED itself. Conversely, some men with normal testosterone still experience ED due to circulation or nerve-related issues.
Research shows that among men who present with ED, as many as 35% may have low testosterone, though prevalence varies depending on the threshold used. This overlap means that testing hormone levels should be part of a comprehensive ED assessment, especially because only a small proportion of men with symptoms are formally diagnosed. In a UK survey, 31% of men reported low libido and 27% reduced erectile strength, but under 5% had a confirmed testosterone deficiency.
Recognising Symptoms of Low Testosterone
Low testosterone can affect multiple aspects of health beyond sexual performance. Understanding the most common signs can help identify whether further investigation is needed.
- Low sex drive or reduced interest in sexual activity
- Erectile difficulties or fewer morning erections
- Persistent fatigue or low energy
- Loss of muscle strength and increased body fat
- Mood changes such as irritability or low motivation
- Poor concentration or mental “fog”
- Disturbed sleep or reduced recovery after exercise
The MansMatters Approach to Low Testosterone and Erectile Dysfunction
At MansMatters, we take a comprehensive approach to understanding how low testosterone and erectile dysfunction are connected. Rather than focusing on symptoms alone, we start by identifying what’s driving the issue, whether it’s hormonal imbalance, poor blood flow, nerve function, or lifestyle factors.
Once the underlying cause is clear, we design a tailored plan that uses diagnostic insight and non-invasive technologies to help restore sexual performance naturally.
Comprehensive Testing and Assessment
Accurate diagnosis begins with detailed hormone and function testing. This helps determine whether testosterone imbalance is contributing to ED or if other physical or metabolic factors are involved. MansMatters uses advanced diagnostic tools to measure key hormonal and health markers, including:
- Total testosterone levels
- Free (active) testosterone levels
- Oestrogen and cortisol balance
- SHBG (Sex Hormone Binding Globulin)
- DHEA and other relevant markers
This precise evaluation forms the foundation for every treatment plan, ensuring that therapies target the real cause of performance issues rather than just masking the symptoms.
Tailored Treatment Programmes
Once results are reviewed, a treatment plan is created based on your specific needs and test findings. For some men, improving circulation is the priority. Focused Shockwave Therapy may be recommended to stimulate new blood vessel growth and enhance blood flow, helping restore natural erectile function.
For others, reducing stress and improving recovery can make the greatest difference. NESA Technology helps regulate the nervous system, promoting better sleep and hormonal stability that support energy, mood and sexual health.
In many cases, lifestyle adjustments play a crucial role too. Structured plans that include exercise, balanced nutrition and quality rest can positively influence testosterone function and long-term performance.
By combining targeted diagnostics with advanced non-invasive treatments, MansMatters provides an integrated path toward improved erectile function and overall wellbeing.
When to Seek Help
If you’ve noticed persistent changes in libido, energy, or erectile quality, it’s important to seek professional assessment rather than self-diagnose. Erectile dysfunction and low testosterone often overlap with other contributing factors such as poor circulation, stress, or metabolic conditions, which is why accurate testing is vital.
At MansMatters, we specialise exclusively in men’s sexual health, combining hormonal evaluation with vascular and neurological assessment to pinpoint the exact cause of performance concerns. This allows for targeted, personalised treatment that addresses every aspect of male sexual wellbeing.
Conclusion
Low testosterone can play a role in erectile dysfunction, but it is rarely the only cause. Identifying whether hormonal imbalance, blood flow, or lifestyle factors are driving the issue is key to lasting results. Through diagnostic precision and multi-technology care, MansMatters helps men regain control of their sexual health safely and effectively.
Take the Next Step
If you’ve noticed changes in performance, energy, or libido, MansMatters can help. Our specialists use advanced testing and non-invasive treatments to identify the cause and create a tailored plan. Book your free consultation today to start improving your sexual health and confidence.
FAQs
Can low testosterone cause weak erections?
Yes, low testosterone can contribute to weaker or less frequent erections, but it is rarely the only cause. Other factors such as blood flow, nerve function and stress levels often play a role too.
Does testosterone replacement improve erectile dysfunction?
Testosterone therapy may help some men whose ED is linked to confirmed hormone deficiency. However, it is not effective if testosterone levels are normal or if circulation and nerve issues are the primary cause.
How does low testosterone affect sexual performance?
Low testosterone can reduce libido, energy levels and stamina, which indirectly impacts sexual performance. Identifying whether these symptoms are hormonal or physical is key to proper treatment.
Can stress and low testosterone cause erectile dysfunction?
Yes, chronic stress increases cortisol, which can interfere with testosterone activity and contribute to ED. Managing stress through therapies that support nervous system balance can help restore performance.
What are the signs of low testosterone in men?
Common signs include low sex drive, fatigue, mood changes and reduced muscle strength. A blood test is the only reliable way to confirm a testosterone imbalance.
How do you test for low testosterone and ED?
A simple blood test measures total and free testosterone, along with related hormones like oestrogen, cortisol and SHBG. Additional assessments may check circulation, nerve function and overall health.
Can lifestyle changes improve low testosterone and ED?
Yes, regular exercise, a balanced diet and better sleep can naturally support testosterone levels and improve erectile function. These habits also enhance blood flow and energy, which are vital for performance.
When should I see a doctor for erectile dysfunction?
You should seek assessment if erectile difficulties persist for several weeks or affect your quality of life. A specialist clinic like MansMatters can identify whether the cause is hormonal, vascular, or psychological and provide the right care plan.
About the Author
Mr. Leon Almashan
Mr. Almashan is a recognised specialist in advanced, non-surgical treatments for men’s health conditions, including Erectile Dysfunction and Peyronie’s Disease.
A graduate of St. George’s Medical School, he has developed innovative treatment protocols that have supported improved quality of life for 1000’s of patients worldwide.
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- Erectile Dysfunction (15)
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- Mental Health (3)
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- Peyronie's Disease (5)
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- Related medical conditions (4)
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