by Dr. Fred Harvey, MD   

This month, for the topic of men's health, I want to talk about something of a rather sensitive nature: erectile dysfunction (ED). It can be uncomfortable to discuss, but the issue is common and nothing to be embarrassed about.  

There is a massive global industry focused on resolving ED. However, it focuses on material satisfaction that profits from suffering—an industry which ignores the fact that human sexuality is related to spirituality. After all, it’s through sexual intercourse that life is created. To ensure our sexual physiology operate as it should for both function and pleasure, we need our bodies, minds and spirits to be clear.  

Large amounts of money have been spent on clinical research to explore ED and its causes. Many believe that testosterone is the key to erectile function or dysfunction. It is related to the function of male genitalia, but it is not the only agent responsible for an erection. Many clinical studies point us in a different direction.  

For example, a 2008 “Health in Men Study” from the International Journal of Epidemiology studied 41,000 men in Western Australia. It revealed that a history of diabetes, cardiovascular events, elevated c-reactive protein, triglycerides and homocysteine levels were associated with lower free testosterone levels. Other medical issues including sleep apnea and lower testosterone also directly contribute to ED, according to a more recent study from the PLOS One Journal in 2018. 

More research shows that, while testosterone plays a role in the development of healthy genital anatomy, it is not solely responsible for ED. Male-to-female transgender folks on androgen deprivation therapy still have sexual erections. Testosterone is essential for libido or sexual desire, but testosterone replacement therapy is not required for erectile function. 

Nocturnal erection or “morning wood” is testosterone dependent, whereas sexually induced erections are not, the International Journal of Impotence Research found. It has also been proven that higher testosterone levels do not have a significant impact on erectile function; thus, the “anti-aging” approach to hormones is possibly both excessive and unnecessary, points out the American Journal of Medicine.  

The functional medicine approach to ED and testosterone replacement is to identify the root cause of ED. In my clinical experience, what occurs in the mind is the primary determiner of erections. So if you feel stressed out, for example, you could be more susceptible to low testosterone and ED as a result. 

On the other hand, there are some medical conditions that contribute massively to ED as well. Inflammation causes low testosterone. Arthritis, phlebitis, myocarditis, iritis, rhinitis and dermatitis cause inflammation. So there could be more to discover and more to uncover in the world of men’s health. Before committing to a lifetime of hormone injections, it would be wise to consider a comprehensive evaluation to look for the root cause of ED, rather than simply treating the effect with a shot of testosterone. 

If you want to discover the root cause of your ED or other health issues, call Dr. Harvey’s office, Functional Medicine Florida (formerly known as The Harvey Center), at 941-929-9355. You can also listen to Dr. Harvey talk about these issues and many other health topics each Monday, 10 a.m., on 88.5FM WMNF radio, as he hosts “The Healthy Steps Radio Show. Dr. Fred Harvey is the Medical Director of Functional Medicine Florida. He is quadruple board-certified in Internal Medicine, Geriatric Medicine, Functional Medicine and Holistic-Integrative Medicine, specializing in chronic illness recovery, prevention and defiant aging. For more information, visit FunctionalMedicineFlorida.com.