Overcoming Erectile Issues: Testosterone Levels and Lifestyle Changes

Experiencing erectile dysfunction during intercourse can be a common issue?

Hello Doctor, I am 30 years old.
Recently, I noticed that I can achieve a full erection during intercourse, but I can only maintain it for less than a minute.
It becomes soft before penetration, making it impossible to insert into the vagina.
A few days ago, I visited a nearby urology clinic regarding this issue.
The doctor advised me to undergo a health check, and the results showed my testosterone level at 324 ng/dL (reference range 280-800).
The doctor mentioned that at my age, it should ideally be around 400, so 324 is somewhat low.
He suggested testosterone supplementation, and I received an injection that lasts for a month.
However, I found online that lifestyle changes and exercise can help improve the levels, and I was tested in the evening, while it is said that morning levels are typically highest.
The doctor was quite decisive in administering the injection based on the results.
Are there any potential side effects? After the injection, I experienced dizziness and nausea, and I plan to stop after one month.
Will this help avoid related side effects? Additionally, will it affect my body's natural testosterone production?
Returning to my original issue, the loss of erection before penetration—could lifestyle changes, exercise, and reducing masturbation help? If I seek medical treatment, are there other methods available besides medications like Viagra? Thank you.

ricky, 30~39 year old female. Ask Date: 2016/04/15

Dr. Li Xinyi reply Urology

Testosterone level is 324 ng/dl (reference range 280-800).
It is possible to consider testosterone supplementation.
Changing lifestyle and exercising can further increase the levels, and since I was tested in the evening, it is noted that morning levels are typically the highest.
It is advisable to maintain a healthy lifestyle and monitor the levels, but it is also recommended to continue consulting with a urologist for further evaluation and discussion with the physician.

Reply Date: 2016/04/15

More Info

Erectile dysfunction (ED) can be a complex issue that often involves both physiological and psychological factors. Your situation, where you can achieve an erection but struggle to maintain it during intercourse, is not uncommon and can be influenced by various aspects, including testosterone levels, lifestyle choices, and emotional well-being.

Testosterone Levels and Their Impact
Your testosterone level of 324 ng/dL is indeed on the lower end of the normal range for a 30-year-old male. Testosterone plays a crucial role in sexual function, including libido and the ability to maintain an erection. While your doctor has suggested testosterone replacement therapy (TRT) to address your low levels, it's essential to consider the potential side effects of such treatment. Common side effects of TRT can include:
- Increased risk of cardiovascular issues
- Mood swings or changes in emotional state
- Sleep apnea
- Acne or oily skin
- Increased red blood cell count, which can lead to blood clots
It's also worth noting that testosterone therapy can suppress your body's natural testosterone production over time. This means that if you stop the therapy after a month, your body may not immediately return to its previous testosterone production levels, which could lead to a temporary dip in your testosterone levels.

Lifestyle Changes and Their Benefits
Before committing to long-term testosterone therapy, it may be beneficial to explore lifestyle changes that can naturally boost testosterone levels and improve erectile function. Here are some strategies:
1. Regular Exercise: Engaging in regular physical activity, particularly strength training and high-intensity interval training (HIIT), can significantly boost testosterone levels. Exercise also improves blood circulation, which is crucial for erectile function.

2. Healthy Diet: A balanced diet rich in whole foods, healthy fats (like omega-3 fatty acids), lean proteins, and plenty of fruits and vegetables can support hormone production. Foods high in zinc, such as nuts, seeds, and lean meats, are particularly beneficial for testosterone levels.

3. Weight Management: Maintaining a healthy weight is essential, as obesity can negatively impact testosterone levels and contribute to erectile dysfunction.

4. Sleep Hygiene: Quality sleep is vital for hormone regulation. Aim for 7-9 hours of sleep per night, and establish a regular sleep schedule.

5. Stress Management: Chronic stress can lead to elevated cortisol levels, which can negatively affect testosterone production. Techniques such as mindfulness, meditation, and yoga can help manage stress levels.

6. Limit Alcohol and Avoid Smoking: Excessive alcohol consumption and smoking can both impair erectile function and lower testosterone levels.

Psychological Factors
It's also important to consider the psychological aspects of erectile dysfunction. Anxiety, depression, and relationship issues can all contribute to difficulties in maintaining an erection. If you find that anxiety about performance is affecting your sexual function, it may be helpful to speak with a therapist or counselor who specializes in sexual health.

Alternative Treatments
In addition to lifestyle changes, there are other treatment options available for erectile dysfunction beyond medications like Viagra (sildenafil). These include:
- Counseling or Therapy: If psychological factors are contributing to your ED, therapy can be beneficial.

- Vacuum Erection Devices: These devices create a vacuum around the penis, drawing blood into it and helping to achieve an erection.

- Penile Injections: Medications can be injected directly into the penis to facilitate an erection.

- Urethral Suppositories: These are small pellets that can be inserted into the urethra to induce an erection.

Conclusion
While testosterone replacement therapy may be a viable option for you, it’s essential to weigh the potential benefits against the risks and consider lifestyle changes that can naturally enhance your testosterone levels and overall sexual health. Engaging in regular exercise, maintaining a healthy diet, managing stress, and addressing any psychological factors are all critical components of overcoming erectile dysfunction. If you continue to experience difficulties, discussing alternative treatment options with your healthcare provider may also be beneficial.

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