Symptom guide
Erectile dysfunction and low testosterone
Erectile dysfunction (ED) is rarely caused by low testosterone alone — but the two often overlap. Here is the Australian work-up that tells you which is which.
Two patterns of ED
- Loss of interest pattern — desire is gone before erections fail. More likely hormonal.
- Interest intact, function failing — desire is normal but erections are unreliable. More likely vascular or psychogenic.
The Australian work-up
- GP appointment. Bring your ADAM screen result.
- Morning fasting bloods: total testosterone, SHBG, LH, FSH, prolactin, lipids, HbA1c, FBC. Usually bulk billed.
- Blood pressure check.
- If testosterone is low, repeat on a second morning to confirm.
Treatment options
- PDE5 inhibitors (sildenafil, tadalafil) — first-line, work regardless of testosterone level.
- TRT — only if testosterone is confirmed low. Often combined with a PDE5 inhibitor.
- Cardiovascular risk reduction — statins, blood pressure control, weight loss, smoking cessation.
- Psychological — performance anxiety often layers on top once ED has started; brief therapy helps.
Why this matters beyond the bedroom
ED is one of the earliest warning signs of cardiovascular disease — small penile arteries clog before larger coronary ones. Treating ED as "just" a sexual issue and skipping the cardiovascular work-up is a missed opportunity to catch heart disease early.
People also ask
Can low testosterone cause erectile dysfunction?+
Yes, but usually not on its own. Low testosterone reduces libido and contributes to ED, but most ED in men over 40 has a vascular component (blood flow). A full work-up checks both hormones and cardiovascular risk.
Can treatment help erection problems?+
Erection problems often have causes such as blood vessel health, diabetes, medicines or stress. A doctor will assess these, and check testosterone where appropriate. Any treatment is a doctor's decision, and results are not guaranteed.
Should I get a heart check too?+
Yes. ED is often the earliest warning sign of cardiovascular disease. Most Australian GPs will check blood pressure, lipids, and HbA1c at the same appointment as the hormone panel.
Get matched with a men's health doctor for low testosterone
Leave your details and a partner men's health clinic will call you at a time that suits, to talk about your symptoms and whether a blood test may be appropriate.
Take the free 2-minute symptom check
The ADAM symptom check shows whether your symptoms may be worth discussing with a doctor. You can also request a callback to get matched with a men's health doctor at a partner clinic, by telehealth or in person, for an assessment.
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*Blood tests may be bulk billed where eligible, subject to doctor assessment and clinical indication.