Testosterone & Erections – The Relationship of Testosterone & DHEA to Male Sexual Health

Testosterone & Erections

The Relationship of Testosterone & DHEA to Male Sexual Health

Testosterone

The androgens (male sex hormones – literally “man makers”) are critically involved in healthy male sexual functioning.[1] Testosterone in particular has the following relevant characteristics in this context:

Testosterone…

  • Supports the production of nitric oxide (critical for blood flow to the penis)[2]
  • Modulates the sexual drive.[3]
  • Levels decline with age – roughly 30% of men who report having erectile dysfunction also have clinically low levels of testosterone (and other androgens).[4]
  • Results in decreased ability to sustain erections and poor response to male enhancement drugs like Viagra™ and Cialis™ when in low
  • This is thought to be due to the fact that low levels of testosterone encourage the breakdown of cGMP (cyclic guanosine monophosphate – key signaling molecule in the body that gives rise to erection).
  • Faster breakdown of cGMP induces biological processes that cause men to lose erections. Thus testosterone reduces the effectiveness and poor responses to Viagra™ and Cialis™ which inhibit PDE5, an enzyme critical in the reversal of the erection process.[5]
  • Testosterone levels are important for cardiovascular health.[6]

In addition to the above, low testosterone or low androgen levels (or abnormal ratios of androgens) are linked to depression, diabetes, obesity, cognitive decline, hair loss and osteoporosis. Some of these mentioned conditions are also risk factors for poor erectile function.[7] [8] Men who (having low testosterone levels) actively try to raise their testosterone levels back into normal ranges report better libido, improved erectile function and do not rely on Viagra™ and Cialis™ as much for sexual satisfaction.[9] [10] [11] [12]

DHEA (de-hydro-epi-androsterone)

DHEA is a precursor (building block) for the production of testosterone in the body – therefore it is related to having healthy levels of testosterone.[13] [14] DHEA levels, like testosterone, decline with age – sometimes by up to 80% by 80 years of age.[15] Low DHEA levels have unsurprisingly been linked to erectile dysfunction[16] [17], and DHEA supplementation has been shown to increase sexual drive, sexual satisfaction and overall quality of life.

Therefore DHEA supplementation may improve sexual performance as well as erectile functioning. However, it must be said that merely being able to have a good strong erection does not guarantee satisfactory sexual performance! On the other hand, the ability to gain an erection is considered at minimum a necessary requirement for normal sexual functioning in men.[18] [19]

The bottom line is that men with poor erectile functioning should check their androgen levels with their healthcare practitioner. If those levels are abnormal, then by safely (and preferably naturally) bringing those levels back into youthful ranges they may recover their sexual satisfaction, drive and basic erectile functioning – something that has been proven to reduce men’s reliance on PDE5 (e.g. Viagra™ and Cialis™) inhibitors.

 

[1] Morales A. Androgens are fundamental in the maintenance of male sexual health. CurrUrol Rep. 2011;12(6):453-460.

[2] Kolodny L. (2011) Chapter 17: Men’s Health: Erectile Dysfunction (pg. 971). In: Bope E., Kellerman R. (Eds.), Conn’s Current Therapy (1st ed). Saunders, An Imprint of Elsevier.

[3] Morales A. Androgens are fundamental in the maintenance of male sexual health. CurrUrol Rep. 2011;12(6):453-460.

[4] Burnett A. (2011) Chapter 24: Evaluation and Management of Erectile Dysfunction (pg 721). In: Wein A. (Ed.), Campbell-Walsh Urology (10th ed). Saunders, An Imprint of Elsevier.

[5] Hackett G. Testosterone measurement – mandatory in ALL men with ED. International Journal of Clinical Practice. 2012;66(1):113-113.

[6] Cattabiani C, Basaria S, Ceda GP, Luci M, Vignali A, Lauretani F, . . . Maggio M. Relationship between testosterone deficiency and cardiovascular risk and mortality in adult men. Journal of endocrinological investigation. Jan 2012;35(1):104-120.

[7]Morales A. Androgens are fundamental in the maintenance of male sexual health. CurrUrol Rep. 2011;12(6):453-460.

[8] Kolodny L. (2011) Chapter 17: Men’s Health: Erectile Dysfunction (pg. 971). In: Bope E., Kellerman R. (Eds.), Conn’s Current Therapy (1st ed). Saunders, An Imprint of Elsevier.

[9] Ibid

[10] Morales A. Androgens are fundamental in the maintenance of male sexual health. CurrUrol Rep. 2011;12(6):453-460.

[11] Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81(3):305-312.

[12] Hackett G. Testosterone measurement – mandatory in ALL men with ED. International Journal of Clinical Practice. 2012;66(1):113-113

[13] Maggi M, Buvat J, Corona G, Guay A, Torres LO.Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA). J Sex Med. 2012;23(10):1743-6109.

[14] Oloyo AK, Sofola OA, Nair RR, Harikrishnan VS, Fernandez AC. Testosterone relaxes abdominal aorta in male Sprague-Dawley rats by opening potassium (K(+)) channel and blockade of calcium (Ca(2+)) channel. Pathophysiology. 2011;18(3):247-253.

[15] Maggi M, Buvat J, Corona G, Guay A, Torres LO.Hormonal Causes of Male Sexual Dysfunctions and Their Management (Hyperprolactinemia, Thyroid Disorders, GH Disorders, and DHEA). J Sex Med. 2012;23(10):1743-6109.

[16] MacKay D. Nutrients and botanicals for erectile dysfunction: examining the evidence. Altern Med Rev. 2004;9(1):4-16.

[17] Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. The Journal of urology. Jan 1994;151(1):54-61.

[18] Reiter WJ, Schatzl G, Mark I, ZeinerA, Pycha A, Marberger M. Dehydroepiandrosterone in the treatment of erectile dysfunction in patients with different organic etiologies. Urol Res. 2001;29(4):278-281.

[19] Reiter WJ, Pycha A, Schatzl G, et al. Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study. Urology. 1999;53(3):590-594.