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In this video we will answer the question can testosterone shots cause ED or erectile dysfunction?  We will also talk a little bit more about how testosterone shots can actually help or enhance erectile function.  If you are using testosterone shots, there are a few instances where this can actually worsen erectile function and you should be aware of those. Can testosterone cause ED? Is this possible? I think this question is interesting because a lot of people assume that more testosterone will make their erections more pronounced and improve their erectile function.  For the most part, this is true.  When your testosterone is low and you bring it up into a normal range, almost always there will be more erectile function.  However there are some distinct physiological areas that can actually get worse.  In a previous video, we talked about how some people can get a paradoxical effect from taking testosterone. For instance generally it will help with anxiety,  help with mood, and it can even help with your ability to stay calm.  In some subsets of people it you can have the reverse effect.  Can Testosterone Cause Anger and Anxiety? So you think you're in the optimal range and really it's just slightly too much for your system. The testosterone is causing more anxiety and more irritability.  This generally has to do with the two issues estrogen and cortisol. With regard to erectile dysfunction the main thing that allows for the penis to get erect has to do with blood flow.  In medical school we learn two things point and shoot.  The point part is related to parasympathetic activity and the shoot part as related to sympathetic activity.  These refer to two parts of the nervous system that control our state of relaxation and excitement. The parasympathetic activity is related to rest and digest.  This activity is associated with relaxation and calming.  If you are not able to get or maintain an erection, this could be that you have too much anxiety, worry, and cortisol.  Cortisol definitely can have a stress provoking  activity. It puts you closer to that stress threshold. Another way to think about it is the time to irritability or anxiety is smaller.  So there is a thinner layer between when you feel calm and when you feel a little bit on agitation, anxiousness or worry. When your testosterone is up at the way high end, you tend to be producing more cortisol and you can get this kind of effect, an inability to maintain or initiate an erection.  You can see this too because it's a lot of times tied in with the psychology. Worry about the performance and all those things. There are definitely some psychological things that make it worse the idea here is too much cortisol and too much testosterone can cause an issue.  As I mentioned earlier, generally speaking more testosterone will help erectile function.  It can hinger in those people that are pushing the edges of normal. The second way testosterone shots can cause ED is through estrogen.  If you think your testosterone shots are causing ED make sure you're checking your estrogen in the middle of your weekly cycle. For instance, if you do your injection on a Monday and you check your estrogen the following Monday you will not see the peak estrogen level.  To ensure you see the peak you want to make sure you check your estrogen 3-5 days after the injection.  If you're doing multiple injections per week then it is not as important.  Regardless you do want to try and catch the peak of that if you're having ongoing erectile dysfunction and you think it could be from your testosterone shot. The other thing is higher doses of testosterone means higher levels of estrogen.  Sometimes people will not be able to see the estrogen as easily if you're doing a standard estradiol test.  If you want to do is make sure you're getting the whole true estradiol levels, test the ultra-sensitive estradioll This uses a more accurate technology called mass spec and liquid chromatography.  This is going to give you a clearer understanding of what your actual conversion to estradiol is . Of course with more estradiol you have means you are counter acting the free testosterone. The testosteorne is what  has the ability to produce more nitric oxide and dilate the arteries. the arteries are what bring more blood flow to the penis to cause the erection.  If you have higher estradiol counter acting the testosterone you are not getting the most benefit out of your testosterone shots. The same is true with other forms of testosterone replacement causing ED or whatever form of testosterone you are using. Hopefully that gives you a better understanding of how testosterone shots can cause ED or erectile dysfunction.  If you have questions about the content here, leave it in the comments below. If you want a customized plant for your testosterone replacement or erectile dysfunction, click on the link below to get started. functional medicine practitioner