Erectile Dysfunction – Could it Be More Than Just a Hormone Imbalance?
Why the Root Cause of Your Erectile Dysfunction May Surprise You
Dave’s story is really interesting…
He came to my clinic looking for a solution to his erectile dysfunction. Unfortunately, Dave is overweight. He drinks too much alcohol, has blood sugar issues, and has inflammation inside his body.
Naturally, the first thing that comes to mind when men complain of erectile dysfunction is low testosterone. And many allopathic doctors would’ve started with testosterone replacement therapy (TRT) as the first line of treatment.
But in Dave’s case, this would’ve only made things worse. Even if I used natural testosterone boosters like herbs, it wouldn’t have helped.
Actually, there’s a startling statistic: up to 25% of men who receive testosterone replacement therapy didn’t even have their hormone levels tested before receiving treatment.(1)
I’m Dr. Martina Sturm of Denver Sports and Holistic Medicine. Because I specialize in treating the whole person, I knew there had to be more to Dave's problem than just low testosterone.
And if I hadn’t taken the time to complete a thorough assessment and lab testing including a comprehensive hormone analysis, I never would have uncovered the root cause of Dave’s erectile dysfunction.
The cause of his problem wasn’t low testosterone, but an imbalance of a different hormone.
If you’re suffering from erectile dysfunction – or any other pain or chronic condition – and your doctors haven’t been able to help you, you’re in the right place.
This week I’m unpacking hormone imbalances in men. And although I’m focusing on what happens when your testosterone is low, let Dave’s case be the perfect example. Common symptoms associated with low testosterone – such as erectile dysfunction – may actually be caused by something else.
What is Testosterone? And What Happens When It's Low?
Testosterone is a hormone crucial for male reproductive tissues and features. It's responsible for male traits like facial hair, a deeper voice, muscle mass, and a masculine body shape.
Beyond physical traits, testosterone plays key roles in:
Sexual development
Sperm production
Muscle and bone health
Sex drive and function
Mood and brain function
Red blood cell production
Men usually have higher testosterone than women, but both genders have it. In men, it's mainly formed in the testes; and in women it’s produced in smaller amounts by the ovaries and adrenals.
Like other hormones, testosterone levels change over time. Things like age, genetics, and lifestyle all play a role in your body’s ability to produce and regulate testosterone.(2)
Low testosterone (low-T) or testosterone deficiency (TD) is when your blood testosterone levels are less than 300 nanograms per deciliter (ng/dL). This is also known as hypogonadism.(3)
Hypogonadism is more common in older men and men who have diabetes and are overweight. One research study found that 30% of overweight men had low testosterone. While only 6.4% of normal weight men had low-T. And of the men with diabetes, 24.5% were more likely to have low testosterone levels compared to 12.5% of men who didn’t have diabetes.(4)
Finding low testosterone levels in Dave’s lab results wouldn't be surprising. Especially when you look at his symptoms of obesity, stress, poor blood sugar regulation, and the inflammation inside his body.
Signs and Symptoms of Low Testosterone In Men
Common in older men, low testosterone is often related to poor libido and erectile dysfunction. In younger men under the age of 40, a crucial symptom is “lack of energy.” (3)
Other symptoms of low testosterone are:
Depression
Fatigue
Poor concentration
Decreased muscle mass
Increased abdominal fat and weight gain
Reduced bone density
Low iron
Irritability
Loss of body hair (2)(3)
Dave’s primary symptom of erectile dysfunction lines right up with low-T. But like I suspected, there was something else contributing to his symptoms.
What Causes Low Testosterone In Men?
Testosterone levels in men naturally drop by 1-2% each year starting at the age of 30.(5)
But the reason your body might struggle to make enough testosterone (hypogonadism) can be described by two main types – primary and secondary hypogonadism.(6)
Primary hypogonadism is when the testicles aren’t producing enough testosterone. This type of hypogonadism can be caused by a congenital abnormality called Klinefelter’s Syndrome. Other causes include:
Undescended testicles
Too much iron your blood
Trauma to one or both testicles
Chemotherapy and radiation
Aging (6)
Secondary hypogonadism occurs when the hypothalamus or pituitary gland are unable to signal to the testes to make adequate levels of testosterone.(6) There are several reasons this can happen, including:
Obesity
Certain medications
Low vitamin D
High blood sugar/insulin resistance
Not enough zinc
Chronic smoking and alcohol use
Hypothyroidism
High levels of stress
Poor gut health (3)(7)(8)(9)
When you look at the causes of low-T and some of Dave’s other issues like obesity and poor blood sugar regulation, you could easily think his erectile dysfunction was caused by secondary hypogonadism.
But when Dave’s labs came back, the results weren’t what you might have expected.
Low Testosterone May Not Be the Cause of Your Erectile Dysfunction
I used the DUTCH Test to detect Dave’s testosterone levels. The DUTCH test not only measures your testosterone levels, but other androgens like:
DHEA-S
Testosterone
5a-DHT
5a and 5b-androstanediol
Etiocholanolone
Androsterone
It also identifies the level of various estrogens and their metabolites in your body.
Normally, a small amount of testosterone made by your testes is converted into estrogen using an enzyme called aromatase. Aromatase activity increases with excess body fat, alcohol, high insulin, and inflammation. The higher your testosterone levels, the more your body converts testosterone into estrogen.(10)
Dave was estrogen-dominant!
Some significant, clinical signs of estrogen dominance are gynecomastia (breast development), testicular atrophy, depression, infertility, and erectile dysfunction.(10)
Most likely, conventional medicine would use hormone replacement therapy (HRT) to address this imbalance. But I’m sure you can see by now that increasing Dave’s testosterone would’ve only heightened his estrogen levels, worsening his symptoms. In other words, we would be putting fuel on the fire by using HRT!
Together Dave and I needed to work on implementing corrective strategies and lifestyle habits to balance his testosterone and estrogen levels. We needed to treat the root cause of his erectile dysfunction.
Important Lifestyle Habits for Long-Lasting Hormonal Balance in Men
Erectile dysfunction, low testosterone, and other hormone imbalances like Dave’s are often associated with other chronic diseases. To help him alleviate his symptoms, I needed to address his underlying conditions like obesity, stress, unregulated blood sugar, and inflammation. (11)
Using a science-backed, functional medicine approach, Dave and I are now working together on a plan to help him achieve better hormone balance. By addressing the root cause of his erectile dysfunction, Dave can experience longer-lasting results and optimal health.
If you’ve been struggling with erectile dysfunction or just haven’t been feeling your best, working with a functional medicine doctor might be the key to getting you back on the road to optimal health.
And because I’m passionate about helping you live your best life, I wanted to offer you some ways to naturally regulate your testosterone levels.
Lose Weight
Obesity increases the risk of erectile dysfunction by 30%. The Massachusetts Male Aging Study showed that a weight gain of about 10 lbs (4 to 5 kg) was similar to 10 years of aging – including a decline of testosterone levels. This study showed that losing as little as 5% of your body weight can significantly help to restore your testosterone levels. (11)
Increase Lean Muscle Mass
High-intensity interval training (HIIT), resistance training, and moderate-intensity aerobic training can improve your testosterone levels by ~17% in older, sedentary males. (12)
Limit Alcohol Intake
Low to moderate alcohol intake has been shown to increase testosterone levels triggered by an increase in detoxification in the liver. And heavy or chronic alcohol intake negatively affects testosterone in men because of increased inflammation and oxidative stress. (13).
Eat a Low-Carb Diet
Eating a low-carb diet with mostly organic whole foods, grass-fed meat, and wild-caught seafood significantly improves your testosterone levels. Other foods like green leafy vegetables, red fruits, and healthy fats are also important.
In addition, eliminating processed foods, foods with a high glycemic load, dairy, refined carbohydrates, and saturated fats are key to minimizing inflammation in your body.
Men who adhered to a low-carb diet with nutrient-dense organic foods saw significant improvements in regulating testosterone levels.(14)
Take Herbs/Supplements
Herbs like fenugreek seed extracts and ashwagandha root can have positive effects on testosterone concentrations in men.(15)
Other herbs including Shilajit and Tongkat Ali are commonly used for boosting testosterone, sexual function, and libido.(16)(17)
Manage Stress
The stress hormone cortisol is testosterone’s “kryptonite.” Cortisol depletes testosterone levels in men. Not only that, but cortisol prevents you from building lean muscle mass and instead promotes fat storage.(18)
Optimize Sleep
Testosterone is heavily influenced by the length and quality of your sleep. A study of young, healthy men showed sleeping fewer than five hours a night was linked to a 10-15% decrease in testosterone.(19)
Like Dave, your hormones are significantly impacted by how you live your life. How you move, the food you eat, your sleep – just to name a few – all matter. Healthy lifestyle choices are necessary in helping you optimize your health and manage your hormone levels as you age.
Working With a Functional Medicine Doctor Helps You Navigate the Hormonal Maze of Erectile Dysfunction
If I had jumped to conclusions and prescribed hormone replacement therapy as part of Dave’s treatment, it would have been the wrong approach. Dave’s story is a classic example of why it’s important to dig deep and uncover the root cause of your unwanted symptoms.
What Dave really needed – and what we’re working together to implement – is a comprehensive treatment plan to help him improve his quality of life. His comprehensive treatment plan includes:
Reversing his metabolic dysfunction
Reducing his inflammation
Regulating his blood sugar
Managing his stress
Improving his sleep
It’s a bit of work, but it’s the right approach to help him restore his hormone levels and have long-lasting, positive results.
Ready to finally discover the root cause of your erectile dysfunction? It could be as simple as low testosterone. Or it could be a complex case like Dave’s, with the culprit being too much estrogen.
At Denver Sports and Holistic Medicine, our goal is to help you understand your body so you can achieve optimal health and well-being. Book a FREE 15-minute consultation today to get started on your path to living your best life!
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