This is the commonest presenting problem in male sexual dysfunction clinics and peaks at the time when the andropause appears.
Man’s ability to have an erection is actually a recurring miracle of hydraulic engineering. Though it is difficult to say precisely what part testosterone plays in helping to produce erections, it certainly both primes the penis and triggers the chain of events which bring an erection about. It is surprising, but gratifying, how often when adequate testosterone therapy is given, all the symptoms of the andropause disappear within a few weeks or months, including erectile difficulties, particularly when other factors contributing to its onset or continuation are dealt with.
Even though it is more difficult to restore function than desire, unless the source of the problems is obviously psychological or mechanical, it seems logical to investigate the testosterone balance of the patient, and restore it to normal as the first stage of treatment. Even if erections are not greatly improved by this alone, libido and confidence usually are. Recent experience has shown that when Viagra and Testosterone are combined, they provide a cure for over 95% of impotence problems.