Surprisingly, low testosterone by itself rarely causes erectile dysfunction, or ED. Low testosterone alone — with no other health problems — accounts for a small minority of men with erectile dysfunction.
Erection problems are usually caused by atherosclerosis — hardening of the arteries. If damaged, the tiny blood vessels supplying the penis can no longer dilate to bring in the strong flow needed for a firm erection. Diabetes, high blood pressure, and high cholesterol are the three main causes of atherosclerosis and erectile dysfunction.
At the same time, low testosterone is a frequent accomplice to atherosclerosis in creating erectile dysfunction. In studies, as many as one in three men mentioning ED to their doctor have low testosterone. Experts believe that in men with other factors causing erectile dysfunction, low testosterone can strongly contribute, making a difficult situation even worse.
Strengthening the connection, low testosterone is linked in some way with many of the conditions that lead to erectile dysfunction:
Although low testosterone isn’t known to cause them, the associations between other medical conditions and low testosterone can be significant.
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