The Link between Inflammation and Low Testosterone and Erectile Dysfunction

EMedicine Health online states that 67% of men age 40 have at least some troubles with erectile dysfunction and that number increases an average 12% for each decade of life afterwards, with men age 79 reporting 90% ED. In 2007 it was estimated that 18 million men suffered ED in the United States, while in 2020 that number had increased to 33 million. The number of men age 20-40 reporting some incidence of ED is 52%. As you can see, it is a bigger problem than is actually acknowledged.

What are the causes?

A study in 2019 published by Harvard Health indicated that chronic inflammation is actually the primary cause. The study reports that often, ED is the first sign that is reported regarding Low Testosterone, heart disease, Venous Insufficiency or kidney disease, but is often overlooked. This may be due to the way in which it is reported. (8) Many men in their 20’s to 50’s won’t report difficulty obtaining an erection. They won’t even report low sex drive, or premature ejaculation. What they report is a general sense of fatigue. Weight gain. Loss of motivation. Interestingly, bloodwork is not often done at this stage. In 47% of cases the patient is prescribed an antidepressant like a Selective Serotonin Reuptake Inhibitor (SSRI).

The study went on to say that medications such as Viagra, Cialis and other vasodilators that were prescribed could actually be more damaging in the long term. This is because the younger the patient, the higher the risk of further damage to the blood vessels. You see, the Blood Vessels in the Penile tissue are the smallest and have the thinnest walls. If you cause them to “Blow out” before age 50, you have a problem beyond age 50. Not only that, But there are significant risks. Curing the problem might be better than the medication. The medications can have side effects of Stroke, heart attack, loss of hearing and vision.

Where does Chronic Inflammation start?

In the blog published in January titled What is Leaky Gut and Do I Have It? I go over what happens when the gut is under attack. This attack can be from the environment outside the body, or the things that you place into the GI system. If you are unsure of the symptoms of Inflammation here are some examples:

How do you know if you have a leaky gut?

• constipation that is chronic and have difficulty going to the bathroom for a bowel movement 2-3 times a day
• bouts of Diarrhea that come on especially after a meal or seem out of the blue
• If you have joint pain in the mornings
• Joint stiffness in the mornings
• Headaches, particularly migraines
• Hives
• Itchy dry skin, even with lotion
• Autoimmune disorders like chronic fatigue, adrenal fatigue, eczema,
• Allergies to food and environment
• Sinusitis, ear infections, Sinus infections
• Runny nose
• Acne

How Does inflammation in the Gut and the Rest of the Body Affect Testosterone and ED?

To start, the gut must have the ability to absorb certain nutrients to produce hormone precursors, Neurotransmitters and Hormones themselves. It turns out that Serotonin (80% of it), which is the feel-good neurotransmitter, is produced in the gut. IT is also required to obtain an erection. If you lack serotonin or you are taking serotonin sparing drugs, Like SSRIs, you will likely have a decreased ability to obtain an erection.

A study published in 2016 (10) indicates that Obesity and a high fat/high calorie diet are both reported to result in changes to gut bacteria and intestinal wall permeability, leading to the passage of bacterial endotoxin (lipopolysaccharide- LPS) from the gut to the blood system (metabolic endotoxemia), where it initiates systemic inflammation. Endotoxin is known to reduce testosterone production by the testis, both by direct inhibition of Leydig cell steroidogenic pathways and indirectly by reducing pituitary Luteinizing Hormone drive.

The problem is that the low T promotes a decrease in good gut bacteria and an increase in non-ovarian Oestrogen production (4). This then leads to further inflammation and lower testosterone. And the cycle continues. The Cycle in itself can lead to Heart disease, Spider Veins, Stroke, and ED.

When you’re ready to talk about correcting the problem, Schedule Here

(1)Blumberg, R., and Powrie, F. (2012). Microbiota, disease, and back to health: a metastable journey. Sci. Transl. Med 4:rv137. doi: 10.1126/scitranslmed.3004184

CrossRef Full Text | Google Scholar

(2)Human Microbiome Project Consortium (2012). Structure, function and diversity of the healthy human microbiome. Nature 486, 207–214. doi: 10.1038/nature11234

PubMed Abstract | CrossRef Full Text | Google Scholar

(3)Harada, N. (2018). Role of androgens in energy metabolism affecting on body composition, metabolic syndrome, type 2 diabetes, cardiovascular disease, and longevity: lessons from a meta-analysis and rodent studies. Biosci. Biotechnol. Biochem. 82, 1667–1682. doi: 10.1080/09168451.2018.1490172

PubMed Abstract | CrossRef Full Text | Google Scholar

(4)Flores, R., Shi, J., Fuhrman, B., Xu, X., Veenstra, T. D., Gail, M. H., et al. (2012). Fecal microbial determinants of fecal and systemic estrogens and estrogen metabolites: a cross-sectional study. J. Transl. Med. 10:253. doi: 10.1186/1479-5876-10-253

PubMed Abstract | CrossRef Full Text | Google Scholar

(5)https://ro.co/health-guide/ed-in-your-20s/#how-many-men-in-their-20s-have-ed

(6)Sooriyamoorthy, T., & Leslie, S. (2021). Erectile Dysfunction. [Updated Aug 12, 2021]. In: StatPearls [Internet]. Retrieved Dec. 8, 2021 from https://pubmed.ncbi.nlm.nih.gov/32965924/

(7) https://www.health.harvard.edu/mens-health/which-drug-for-erectile-dysfunction

(8) https://www.statista.com/statistics/1248479/effects-of-ed-on-relationships-among-us-men/

(9) https://medlineplus.gov/ency/article/004024.htm

(10) Gut Endotoxin Leading to a Decline IN Gonadal function (GELDING) – a novel theory for the development of late onset hypogonadism in obese men

Kelton Tremellen https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918028/

(11)Dopamine and serotonin: influences on male sexual behavior, Elaine M Hull 1, John W Muschamp, Satoru Sato

• DOI: 10.1016/j.physbeh.2004.08.018

(12) https://www.sciencedirect.com/topics/medicine-and-dentistry/estrogen-metabolism