Hypogonadism is the most common cause for endocrinopathy leading to ED, although the endocrine disorders themselves are some of the rarest of all causes of ED.
Most men experience a lowering of their serum testosterone levels with age, but these levels are not low enough to induce ED.
When hypogonadism is suspected of causing ED, treatment with exogenous androgens is recommended if there are no contraindications to its use in this setting. If the ED does not resolve after a finite time of treatment with the exogenous testosterone, other causes (vascular and/or neurologic) must be suspected.
Even men with normal serum testosterone levels may require or request exogenous testosterone therapy because of other constitutional symptoms.
Patients on long-term androgen therapy require follow-up of their PSA, hematocrit, and liver enzymes about every 6 to 12 months.
