Erectile Dysfunction: Testosterone's Role in Fertility

Erectile dysfunction with rapid loss of erection: The impact of testosterone on fertility?

Hello Doctor, I have encountered a problem since I started having sexual intercourse for the first time in the past six months.
My penis does not maintain its hardness for long and becomes soft.
I didn't notice the severity of the issue when I was masturbating.
Now, during sexual intercourse, although I can achieve a full erection, it becomes soft within a minute, making it impossible to continue.
The doctor mentioned it might be psychogenic, but is there any testing I can undergo to determine if it is organic erectile dysfunction? Additionally, I have recently started considering fertility.
Previously, a urologist administered testosterone injections to me.
Can testosterone be supplemented continuously, and will it affect fertility? Thank you.

A-Ming, 30~39 year old female. Ask Date: 2016/07/19

Dr. Chen Jiansheng reply Urology

Hello, if the symptoms persist for two months without improvement, please consult a urologist for an evaluation of organic erectile dysfunction.
If fertility is a concern, it is not recommended to supplement with exogenous testosterone, as it may suppress your own fertility.
Chen Jian-sheng, Urology Department, Hsin Ying Hospital.

Reply Date: 2016/07/19

More Info

Erectile dysfunction (ED) is a complex condition that can be influenced by both psychological and physiological factors. In your case, it seems that you are experiencing difficulties maintaining an erection during sexual activity, which can be distressing, especially as you are considering starting a family. Understanding the role of testosterone in fertility and the potential causes of your ED is crucial for addressing your concerns.

Firstly, it's important to recognize that testosterone is a key hormone in male sexual function. It plays a significant role in libido (sexual desire), erectile function, and overall reproductive health. Low testosterone levels can lead to decreased sexual desire and can contribute to erectile dysfunction. However, it's also essential to note that not all cases of ED are due to low testosterone; psychological factors such as anxiety, stress, or relationship issues can also play a significant role.

Given your situation, it would be prudent to undergo a thorough evaluation to determine the underlying cause of your erectile dysfunction. This evaluation typically includes:
1. Medical History: A detailed history of your sexual function, any medical conditions, medications you are taking, and lifestyle factors such as smoking, alcohol use, and exercise.

2. Physical Examination: A physical exam can help identify any anatomical issues or signs of hormonal imbalances.

3. Blood Tests: These tests can measure testosterone levels, as well as other hormones such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which can provide insight into your hormonal health. Additionally, tests for thyroid function, blood sugar levels, and cholesterol may be conducted, as these can also affect erectile function.

4. Psychological Assessment: If psychological factors are suspected, a mental health evaluation may be beneficial to address any underlying anxiety or stress that could be contributing to your ED.

Regarding your question about testosterone supplementation, it is essential to approach this carefully. While testosterone replacement therapy can improve libido and erectile function in men with low testosterone levels, it can also have implications for fertility. Testosterone therapy can suppress the body's natural production of testosterone, which can lead to decreased sperm production and potentially impact fertility. This is particularly important to consider since you are looking to conceive.

If you are currently receiving testosterone injections, it is crucial to discuss your fertility goals with your healthcare provider. They may recommend monitoring your testosterone levels and possibly adjusting your treatment plan to balance your sexual health and fertility needs. In some cases, medications such as human chorionic gonadotropin (hCG) can be used alongside testosterone therapy to help maintain sperm production.

In summary, erectile dysfunction can stem from various causes, including hormonal imbalances, psychological factors, or a combination of both. A comprehensive evaluation is necessary to determine the underlying cause and appropriate treatment. If testosterone levels are low, supplementation may be beneficial, but it is essential to consider its potential impact on fertility. Open communication with your healthcare provider will be key in navigating these issues and finding a treatment plan that supports both your sexual health and your desire to start a family.

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