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Lab Tests That Can Detect Erectile Dysfunction

To comprehend and address erectile dysfunction (ED) in males, it is essential to assess hormones such as testosterone, prolactin, LH, FSH, estradiol, and SHBG, all of which are included in our Male and Female Hormone Test. Each of these hormones has a unique and important function in the overall health and well-being of males. Enhancing doctors’ understanding of these hormones enables the development of more effective treatment approaches that target the root causes of ED rather than just alleviating the symptoms, hence enhancing the well-being and satisfaction of affected persons.

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Erectile dysfunction (ED) is a common yet sometimes misconstrued condition that impacts a significant number of men, leading to various implications for both sexual and overall physical and psychological wellness. Prompt detection and accurate diagnosis of erectile dysfunction (ED) are crucial for effective treatment and therapy. Laboratory testing has significant importance in this particular situation. This provides crucial insights into the fundamental physiological and hormonal factors that might contribute to erectile dysfunction (ED).

nurse holding a vial for lab testing

Through the identification of hormonal imbalances, metabolic illnesses, or other physiological abnormalities, these tests enable healthcare practitioners to tailor therapy strategies that address not just the symptoms but also the root causes of erectile dysfunction. This comprehensive approach leads to a more efficient and customized treatment strategy, enhancing the overall well-being of individuals affected.

Male Hormone and Female Hormone Lab Test

Erectile dysfunction (ED) is a complex condition that can be attributed to several factors, including hormone irregularities. The most closely correlated tests in male and female hormone assays for evaluating potential causes of erectile dysfunction are:

Testosterone is the primary androgenic hormone in males and has a crucial role in several aspects of sexual health:

Libido (Sex Drive)

Testosterone is essential for maintaining a robust sexual desire.1 Diminished levels of testosterone are often associated with a reduced inclination towards sexual activity, which can lead to the occurrence of erectile dysfunction.

Erection Maintenance

Testosterone facilitates the physiological mechanism of achieving and maintaining an erection.2 Proper erectile function needs adequate testosterone levels, which are influenced by several components including the neurological and circulatory systems.

Nitric Oxide Synthesis

Testosterone is believed to control the body’s production of nitric oxide, a substance that has a crucial role in relaxing the smooth muscle of the penis, hence facilitating increased blood flow and erection.3

Psychological Well-being

Testosterone bears an effect on mood and overall state of well-being.4 Insufficient amounts of a certain substance might lead to feelings of despair, worry, and a reduced sense of overall satisfaction, which can negatively affect sexual performance.

Penile Health

Persistent low levels of testosterone might lead to alterations in the penile tissue’s structure, perhaps worsening erectile dysfunction as time goes on.5

Testing prolactin levels can serve as a valuable diagnostic technique for assessing erectile dysfunction. The pituitary gland secretes prolactin, a hormone primarily associated with lactation in females but also performs crucial functions in the male body. The significance of prolactin testing in relation to erectile dysfunction (ED) is as follows:

Hyperprolactinemia and ED

Hyperprolactinemia, characterized by elevated levels of prolactin, can lead to erectile dysfunction (ED).6 Elevated levels of prolactin can impede the secretion of gonadotropin-releasing hormone (GnRH), leading to reduced testosterone synthesis. The decline in testosterone levels might potentially contribute to erectile dysfunction, as testosterone plays a crucial role in sexual function.

Impact on Libido

Elevated levels of prolactin can also diminish sexual desire or libido.7 This occurs due to the inhibitory effect of prolactin on dopamine, a neurotransmitter that plays a role in sexual desire and function. Diminished sexual desire can significantly contribute to erectile dysfunction.

Indirect Effects on Erectile Function

In addition to modifying sexual desire and testosterone levels, an excess of prolactin can indirectly affect erectile function. Men with hyperprolactinemia may experience heightened levels of anxiety or sadness due to their condition, perhaps exacerbating erectile dysfunction.8

Pituitary Gland Disorders

Increased levels of prolactin may indicate the presence of pituitary gland disorders, such as a prolactinoma. These illnesses can have diverse effects on the body, including alterations in sexual function.

Testing for Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) might provide valuable insights into the diagnosis of erectile dysfunction (ED), since both hormones have significant roles in the male reproductive system. The significance of LH and FSH tests in the context of erectile dysfunction (ED) lies in the following reasons:

Regulation of Testosterone Production

Luteinizing hormone (LH) is very important for the synthesis of testosterone in the testes.9 It stimulates the Leydig cells in the testes to produce testosterone. Testosterone, a crucial hormone for male sexual function, plays a significant role in desire and the ability to get and maintain an erection. Consequently, fluctuations in LH levels can directly impact erectile function. Insufficient amounts of luteinizing hormone (LH) can lead to decreased synthesis of testosterone, hence contributing to erectile dysfunction (ED).


Follicle-stimulating hormone (FSH) plays a crucial role in the regulation of spermatogenesis, which refers to the process of sperm generation. FSH levels have a stronger correlation with fertility than erectile function. However, imbalances in FSH levels may indicate underlying disorders in the testes or pituitary gland, which can impact sexual health and performance.

Pituitary Gland Function

The pituitary gland secretes both luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Abnormally elevated or diminished levels of these hormones may indicate a dysfunction in the pituitary gland or hypothalamus, which might hinder the production of other hormones that have a role in sexual function.

Hypogonadism Diagnosis

Assessing LH and FSH levels is crucial for identifying different types of hypogonadism. Primary hypogonadism, which stems from testicular dysfunction, is marked by heightened levels of LH and FSH due to reduced testosterone feedback. Secondary hypogonadism, resulting from hypothalamic or pituitary dysfunction, is defined by decreased or normal levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Both conditions can result in decreased amounts of testosterone and erectile dysfunction.

Overall Hormonal Health

The levels of LH and FSH can offer valuable information on the general hormonal well-being and equilibrium of the male body. Hormonal irregularities can significantly contribute to the occurrence of erectile dysfunction.

Estradiol testing can be valuable in evaluating erectile dysfunction (ED) in males, however it is often less straightforward than hormones such as testosterone. Estradiol, a kind of estrogen, is present in low quantities in males and has an impact on libido, erectile function, and overall sexual well-being. The significance of estradiol testing in relation to erectile dysfunction (ED) is as follows:

Estradiol and Testosterone Balance

Estradiol is synthesized in males through the conversion of testosterone. Optimal levels of testosterone and estradiol are crucial for maintaining proper sexual function. Elevated estradiol levels relative to testosterone might hinder sexual performance and result in erectile dysfunction (ED).

Estradiol and Testosterone Balance

Estradiol is synthesized in males through the conversion of testosterone. Optimal levels of testosterone and estradiol are crucial for maintaining proper sexual function. Elevated estradiol levels relative to testosterone might hinder sexual performance and result in erectile dysfunction (ED).

Impact on Libido

Estradiol impacts sexual desire in both males and females. Elevated levels can diminish sexual libido, a crucial component of sexual well-being, and perhaps contribute to erectile dysfunction.11

Estradiol's Effect on Erectile Tissue

Evidence indicates that estradiol may have a role in maintaining the well-being of erectile tissue.12 Excessive amounts of estradiol can negatively impact this tissue, impairing the ability to achieve or sustain an erection.

Indicator of Aromatase Activity

Elevated estradiol levels in males may indicate heightened aromatase enzyme activity, responsible for converting testosterone to estradiol.13 This might potentially result in a decrease in available testosterone, which could impact sexual function.

Associated Health Conditions

Increased levels of estradiol in males may be associated with additional health conditions such as obesity, liver disease, or thyroid disorders, all of which can hinder sexual performance and contribute to erectile dysfunction.

SHBG testing is crucial in diagnosing erectile dysfunction. Sex hormone-binding globulin (SHBG) is a protein that attaches to sex hormones, namely testosterone and estradiol, in the bloodstream. Gaining a comprehensive understanding of the action of sex hormone-binding globulin (SHBG) is crucial for evaluating sexual health and performance. The relevance of SHBG testing in the context of ED is as follows.

Regulation of Testosterone Availability

Sex hormone-binding globulin (SHBG) attaches to testosterone, hence influencing its availability for biological activity.14 Only a minuscule quantity of testosterone in the bloodstream is “free” or unattached, indicating that it is biologically active and capable of entering cells to exert its effects. Elevated quantities of SHBG have the capacity to bind a greater amount of testosterone, reducing the quantity of unbound testosterone that is accessible for utilization by the body. Elevated levels of SHBG can result in erectile dysfunction (ED) due to its impact on sexual function, including desire and erectile function, which are regulated by testosterone.

Balance Between Testosterone and Estrogen

SHBG also attaches to estradiol, a kind of estrogen.15 Fluctuations in SHBG levels can disturb the balance of testosterone and estrogen in the body, which is crucial for sexual well-being. Deviant amounts of SHBG can disrupt the balance and lead to sexual dysfunction.

Indicator of Overall Hormonal Health

Elevated or decreased SHBG levels may indicate abnormalities in overall hormonal well-being. SHBG levels can be influenced by several factors, such as liver function, thyroid hormones, and obesity. Elevated SHBG levels are frequently observed in individuals with hyperthyroidism and liver disease, whereas decreased levels are associated with obesity, insulin resistance, and hypothyroidism.

Diagnosis of Hypogonadism

When dealing with erectile dysfunction (ED), it is common to perform SHBG testing with total testosterone testing. The ratio of total testosterone to SHBG can help determine if a man has low bioavailable testosterone, which can result in a diagnosis of hypogonadism, a contributing factor to erectile dysfunction.


The assortment of male and female hormone laboratory testing plays a crucial role in comprehending the intricacies of erectile dysfunction (ED). These tests are valuable for detecting hormonal irregularities that might cause erectile dysfunction (ED) and also offer a comprehensive assessment of an individual’s hormonal well-being. Analysis of key hormones such as testosterone, estradiol, prolactin, LH, FSH, and SHBG can offer healthcare practitioners with valuable insights into the intricate hormonal connections that regulate sexual function. Acquiring this understanding is crucial for the development of effective treatment methods that surpass mere symptom relief and target the underlying causes of ED.

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[9] Oduwole OO, Huhtaniemi IT, Misrahi M. The Roles of Luteinizing Hormone, Follicle-Stimulating Hormone and Testosterone in Spermatogenesis and Folliculogenesis Revisited. Int J Mol Sci. 2021 Nov 25;22(23):12735. doi: 10.3390/ijms222312735. PMID: 34884539; PMCID: PMC8658012.

[11] Chen T, Wu F, Wang X, Ma G, Xuan X, Tang R, Ding S, Lu J. Different levels of estradiol are correlated with sexual dysfunction in adult men. Sci Rep. 2020 Jul 29;10(1):12660. doi: 10.1038/s41598-020-69712-6. PMID: 32728148; PMCID: PMC7391660.

[12] Xu ZH, Xu XH, Pan D, Liu TY, Yuan MZ, Jiang S, Guan Y, Zhao ST. Effect of estradiol on penile erection: a cross-sectional study. Transl Androl Urol. 2019 Dec;8(6):574-582. doi: 10.21037/tau.2019.10.15. PMID: 32038953; PMCID: PMC6987613.

[13] Chan HJ, Petrossian K, Chen S. Structural and functional characterization of aromatase, estrogen receptor, and their genes in endocrine-responsive and -resistant breast cancer cells. J Steroid Biochem Mol Biol. 2016 Jul;161:73-83. doi: 10.1016/j.jsbmb.2015.07.018. Epub 2015 Aug 13. PMID: 26277097; PMCID: PMC4752924.

[14] Li H, Pham T, McWhinney BC, Ungerer JP, Pretorius CJ, Richard DJ, Mortimer RH, d'Emden MC, Richard K. Sex Hormone Binding Globulin Modifies Testosterone Action and Metabolism in Prostate Cancer Cells. Int J Endocrinol. 2016;2016:6437585. doi: 10.1155/2016/6437585. Epub 2016 Nov 20. PMID: 27990161; PMCID: PMC5136390.

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