Primary Causes & Action Plans
Testosterone
Low testosterone directly impairs erectile function Testosterone is required for erectile function, sexual desire, and penile blood flow. Deficiency directly causes ED.
Target > 600 ng/dL
Suggested Action Plan
If testosterone is low, testosterone replacement therapy is straightforward and typically restores ED within 4-8 weeks.
Fasting Insulin
Insulin resistance impairs endothelial function and erectile capacity Insulin resistance damages the endothelium, reducing NO production and blood flow, impairing erections. Restoring insulin sensitivity often restores erectile function.
Target < 5 uIU/mL
Suggested Action Plan
Reduce fasting insulin through low-carb diet, exercise, and weight loss. This is often the most powerful intervention for ED.
ApoB
Arterial plaque accumulation impairs penile blood flow Elevated ApoB indicates atherosclerosis affecting small arteries, including penile arteries. ED is often an early sign of coronary artery disease.
Target < 80 mg/dL
Suggested Action Plan
Lower ApoB through diet, exercise, and weight loss. If very elevated, statins or PCSK9 inhibitors may be needed. Treating cardiovascular disease directly improves ED.
hs-CRP
Endothelial inflammation impairs NO production and erectile function Chronic inflammation damages the endothelium, reducing NO availability. Anti-inflammatory interventions often improve ED.
Target < 1.0 mg/L
Suggested Action Plan
Lower hs-CRP through Mediterranean diet, omega-3 supplementation, exercise, stress management. Retest in 3 months.
HbA1c
Blood sugar control; hyperglycemia damages endothelial function Uncontrolled blood sugar damages blood vessels throughout the body, including penile arteries. ED is common in diabetics.
Target < 5.2% (optimal)
Suggested Action Plan
If HbA1c is elevated, aggressive blood sugar control through diet and exercise directly improves erectile function.