Combining Erectile Dysfunction Treatments with TRT

Posted: December 23, 2021

Erectile dysfunction (ED) is a common but serious condition that can significantly affect your quality of life. Your sex life is an important part of your overall well-being and your relationships. Many men suffer from ED, which is a condition where you are unable to achieve or maintain an erection sufficient for sex. Your risk for ED increases with age, as does your risk for low testosterone, another common condition that can negatively affect your life. Many men experience both conditions at once. However, you might be wondering whether it’s safe or effective to treat both ED and low testosterone at the same time. We will explore the differences between ED treatments, testosterone replacement therapy (TRT), and when your health management strategies may include both treatment options. 

If you have both erectile dysfunction and low testosterone, our doctors may recommend taking both ED treatments and TRT.

Common Treatments for Erectile Dysfunction

Before we look at whether it’s safe to take both erectile dysfunction drugs and testosterone at the same time, it’s important to know a little more about ED medications.

The most popular treatment options for ED are phosphodiesterase type 5 inhibitors, or PDE5Is for short. These medications include sildenafil (the generic form of Viagra™) and tadalafil (the generic form of Cialis™). Both sildenafil and tadalafil come in pill form that you take orally. There are a few differences between these two erectile dysfunction treatment options. The main difference is that sildenafil stays in your system for just four to six hours, which means you typically need to get the timing right when taking the medicine. For instance, our doctors may recommend taking it 30 minutes to four hours before sex. Tadalafil stays in your system for up to 18 hours, so generally you can take it daily without worrying about the exact timing of sexual activity. Of course, you should always follow your doctor’s instructions for taking your medication. 

PDE5Is help block the PDE5 enzyme in your body. This enzyme is responsible for contracting the walls of your blood vessels. When the blood vessels leading to the penis are contracted, they are narrower. This limits blood flow to the penis and may negatively affect erections. PDE5Is like sildenafil and tadalafil help the blood vessels leading to the erectile tissues relax and open up more. In turn, this can help allow more blood into the penis.  

TRT Helps with Low Testosterone Levels

By contrast, TRT is a treatment option to help increase testosterone levels in your blood. Testosterone is a hormone that plays many key roles in the body. It’s responsible for things like muscle mass and red blood cell production. Experts also believe it is essential for sex drive. Many men suffer from low testosterone levels, which is where your body produces less testosterone than is normal for someone your age. This can cause many different symptoms, including:

• Fatigue
• Depression
• Irritability
• Anxiety
• Unexplained weight gain
• Loss of muscle mass
• Low libido

TRT is a treatment option for people with low testosterone levels. Our providers typically recommend regular testosterone injections to help increase the amount of testosterone in your body if you have low testosterone. This may help alleviate many of the symptoms you may experience with low T.

Can You Take Erectile Dysfunction Medications and Testosterone at the Same Time?

You might have many questions about treating ED and low testosterone. For example, should you take PDE5 inhibitors, testosterone, or both? Is it safe to use both PDE5 inhibitors and testosterone? Of course, you should always talk to one of our providers about your specific circumstances. Your individual health does affect whether it makes sense for you to take both ED medications and testosterone treatments. However, for most men it is safe to take both at the same time if you have both health conditions. Generally speaking, these different therapies treat different things. Therefore, you may be able to take them simultaneously. Currently, there are no known interactions between testosterone and either sildenafil or tadalafil. 

Erectile Dysfunction Medications Address Blood Flow to the Penis

Erectile dysfunction medications address the most common physical causes of ED. Most cases of ED are due to blood flow issues, like those you may experience from heart disease, diabetes, or high blood pressure. Atherosclerosis, a hardening of your arteries, is one of the most common causes of erectile dysfunction. Risk factors for atherosclerosis include diabetes, high blood pressure, smoking, and high cholesterol. When the arteries leading to the penis harden, it can be difficult to get enough blood flow to achieve and sustain an erection hard enough for sex. As we mentioned earlier, PDE5Is are an effective erectile dysfunction medication because they help relax the blood vessels leading to the penis. 

TRT Helps Improve Libido, Mood, and Energy

By contrast, testosterone can help treat some other factors that may negatively impact your sex life. For instance, low libido, low energy, and mood changes are all common symptoms of low testosterone. These symptoms can also lead to erectile dysfunction. However, ED from low testosterone typically isn’t due to physical issues with blood flow. Instead, low testosterone can reduce your sex drive. 

Low libido from testosterone deficiency can make you feel less interested in sex, while mood changes and fatigue can make it difficult to act on your sexual impulses. If you’re tired, depressed, anxious, or irritable, sex can seem more like a chore. Many men may experience ED due to low testosterone levels because of these symptoms. However, it’s less common to see ED caused solely by low testosterone levels. Low sex drive from testosterone deficiency can be a factor in your ED, though.

TRT can help relieve some of the symptoms of low testosterone, including those that affect your sex life. Therefore, testosterone injections may be an important part of your overall health management. It can also be helpful for your ED treatment program if you experience low libido. Even if you’re suffering from blood flow issues to the penis that require PDE5Is, TRT can also help address libido changes due to low testosterone. 

Combining Testosterone and Erectile Dysfunction Treatments May Improve Results

We have mentioned that using testosterone and PDE5Is is typically safe for men with low testosterone and ED. Therefore, our healthcare professionals may recommend using both therapies for your overall health. Testosterone injections may relieve low T symptoms like low energy levels, mood changes, and low libido, while ED drugs may help increase blood flow to the penis to enhance erectile function. Some studies have even found that combining these treatments may be beneficial for men with both conditions. 

Because of the link between sex drive, testosterone, and erections, many researchers have wondered whether testosterone may also help improve results from ED therapies. Research is still ongoing, but several studies have found that testosterone may enhance the effectiveness of PDE5 inhibitors for men with low testosterone levels. One study from 2012 found that men with severely low testosterone levels had improved erectile function scores when they took both tadalafil and testosterone treatments. 

A similar study from 2006 looked at testosterone’s effects on sildenafil. This study found that 12 out of 21 men taking both sildenafil and testosterone saw significant improvements in sexual satisfaction and erectile function. Another study, published in 2020 also saw erectile function improvements in men with ED and low testosterone who used both testosterone and PDE5 inhibitors. Therefore, if you have both low testosterone and ED, our providers may recommend using both treatments to help with your symptoms.

Managing Your Health as a Whole at Low T Center

Our providers at Low T Center are dedicated to helping you manage your overall health. Our team offers diagnosis, treatment, and treatment optimization for a wide range of conditions. We offer services for common health problems like erectile dysfunction, low testosterone, and sleep apnea. As a men’s health clinic, our goal is to help you improve your health as a whole through customized treatment solutions. We offer convenient, affordable health care for men. Make an appointment today to discover the Low T Center difference. 

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Disclaimer: This article is made available for general, entertainment and educational purposes only. The opinions expressed herein do not necessarily reflect those of Low T Center. You should always seek the advice of a licensed healthcare professional.