Erectile Dysfunction: Causes, Treatments, and Hormone Therapy

Q: Erectile Dysfunction: Causes, Treatments, and Hormone Therapy

Anonymous： Hello. 1. Continuous monitoring of hormones is sufficient; you can stop once levels are adequate. 2. Recovery is possible. The key is to maintain a regular lifestyle, engage in regular exercise, eat a healthy diet, and avoid smoking and alcohol. <br

Erectile dysfunction

Hello, Dr.
Hsu: Recently, I have noticed issues with my erections, primarily during sexual intercourse where the hardness is not what it used to be.
It tends to soften midway, requiring additional stimulation to regain hardness, but even then, the firmness feels inadequate.
I also occasionally experience premature ejaculation.
Since I have never encountered such issues before, it has made me quite anxious.
After visiting a urology clinic and undergoing blood tests, I found out that my testosterone levels are low, so I was prescribed a testosterone topical gel and erectile dysfunction medication.
I would like to ask you: 1.
Will I need to supplement testosterone for the rest of my life? 2.
I am still quite young, and after looking at educational resources, I found that low testosterone is typically a symptom of menopause.
If I eat more seafood and maintain a good exercise routine, is it possible for my levels to recover? I do not want to rely on medication indefinitely! 3.
I have never had a habit of smoking or drinking, and I used to be an athlete, so I really don't understand why my testosterone levels have suddenly dropped.
Could there be other reasons causing erectile dysfunction? 4.
Is the absence of morning erections considered abnormal? Thank you for your response, Doctor!

Nìmíng, 20~29 year old female. Ask Date: 2015/12/04

Dr. Xu Weikai reply Urology

Anonymous: Hello.
1.
Continuous monitoring of hormones is sufficient; you can stop once levels are adequate.
2.
Recovery is possible.
The key is to maintain a regular lifestyle, engage in regular exercise, eat a healthy diet, and avoid smoking and alcohol.
3.
If testosterone levels are low but do not affect daily life, supplementation may not be necessary.
Most testosterone replacement therapies can potentially trigger malignant tumors.
Therefore, it is advised to use them with great caution and preferably choose medications certified by the Ministry of Health and Welfare, FDA, or EU.
4.
Please refer to my previous response regarding morning erections.
I have repeatedly emphasized that for those who can achieve an erection, morning erections have no significant meaning.
If there are any unclear points, feel free to ask again for further discussion and research.
Online responses should only serve as a reference; if necessary, it is still important to seek medical attention at healthcare facilities.
This message is from Dr.
Hsu Wei-Kai, Chief of Urology at Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2015/12/04

More Info

Erectile dysfunction (ED) is a complex condition that can stem from a variety of causes, including hormonal imbalances, psychological factors, and physical health issues. Your concerns about experiencing difficulties with erectile firmness and occasional premature ejaculation are valid, and it’s important to address them comprehensively.

1. Long-term Hormone Replacement: Regarding your question about whether you will need to supplement testosterone for life, it depends on the underlying cause of your low testosterone levels. If your low testosterone is due to a primary testicular issue or a chronic condition, you may require ongoing treatment. However, if it is secondary to lifestyle factors or other reversible conditions, there may be a possibility of normalization over time. Regular follow-ups with your healthcare provider are essential to monitor your hormone levels and adjust treatment as necessary.

2. Lifestyle Changes and Recovery: You mentioned the possibility of improving your testosterone levels through diet and exercise. While it is true that a healthy lifestyle can positively influence hormone levels, the extent of recovery can vary. Consuming a balanced diet rich in nutrients, including seafood (which is high in zinc and omega-3 fatty acids), engaging in regular physical activity, and maintaining a healthy weight can all contribute to better hormonal health. However, if your testosterone levels are significantly low, lifestyle changes alone may not be sufficient, and medical intervention might still be necessary.

3. Understanding the Causes of Low Testosterone: It’s understandable to feel perplexed about the sudden drop in testosterone levels, especially given your history as an athlete and your healthy lifestyle choices. Low testosterone can be influenced by various factors, including stress, sleep disturbances, certain medications, and underlying health conditions such as obesity, diabetes, or hormonal disorders. Psychological factors, such as anxiety or depression, can also play a significant role in both testosterone levels and erectile function. It’s crucial to have a thorough evaluation to rule out any other potential causes.

4. Morning Erections: The absence of morning erections can be a sign of erectile dysfunction, but it’s not the only indicator. Morning erections are typically a result of natural hormonal fluctuations during sleep, particularly during REM sleep. If you are not experiencing these, it could indicate a hormonal issue or a psychological component affecting your sexual health. However, it’s essential to consider this in conjunction with other symptoms and discuss it with your healthcare provider.

In summary, erectile dysfunction can be multifactorial, and addressing it often requires a holistic approach that includes medical treatment, lifestyle modifications, and psychological support. It’s important to maintain open communication with your healthcare provider to explore all potential avenues for treatment and to understand the best course of action tailored to your individual needs. Regular monitoring of your hormone levels and overall health will help guide your treatment plan and may lead to improvements in your symptoms over time. Remember, you are not alone in this, and many men experience similar challenges. Seeking help is the first step toward regaining your confidence and sexual health.

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