Men who are impotent are at increased risk for heart attacks and diabetes. (Atherosclerosis, February 2011). The two most common causes of impotence are blood vessel disease (arteriosclerosis) or lack of the male hormone, testosterone. When a man lacks testosterone, he usually has little or no sexual desire. On the other hand, if he still has desire, his testosterone is usually normal but his blood vessels are usually damaged and the same damage that occurs in the penis also occurs in the arteries leading to his heart.
Lack of male hormones is strongly associated with increased blood levels of triglycerides and the bad LDL cholesterol that increase risk for metabolic syndrome, obesity, diabetes, high blood pressure and atherosclerosis. Giving testosterone to men deficient in that hormone lowers levels of triglycerides and the bad LDL cholesterol, and helps to slow the progression of blood vessel damage.
All men who have difficulty achieving erections need to get blood tests for diabetes (HBA1C), testosterone, prolactin (a hormone that causes impotence and is produced by a brain tumor), cholesterol and triglycerides, and have their blood pressure checked. Most of these men will have serious blood vessel damage from arteriosclerosis and will need a program that includes *losing weight if overweight, *starting a supervised exercise program, *restricting refined carbohydrates (sugared drinks and foods made from flour), fried foods and red meat, *increasing intake of fruits and vegetables, and *checking their vitamin D3 (should be greater than 75 nmol/L).
Men who need testosterone replacement should not take testosterone pills because they go from the intestines to the liver to lower the good HDL cholesterol and increase risk for heart attacks. They should use a route that bypasses the liver such as testosterone injections or testosterone gel that is rubbed on the skin.