Erection difficulties
When erections become less reliable, start with answers.
Written by the TRT Optima clinical teamUpdated
Difficulty getting or maintaining an erection can affect intimacy and confidence. Understanding what contributes to the change can help you find appropriate treatment.
TRT Optima helps men in Colombia access physician assessment, relevant testing, and individual care options—with English and Spanish support along the way.
Start with a general question. Personal clinical details can be discussed directly with your physician.
English and Spanish support across Colombia.
Understanding the change
Getting an erection. Keeping it. Understanding what has changed.
Erection difficulties can mean struggling to get an erection, losing it sooner than you would like, or finding that erections have become less consistent.
You do not need to wait until the problem happens every time before asking for help. Explain the pattern you have noticed and how it affects you.
Desire and erections are different
You can want sex and still have difficulty getting or maintaining an erection. Reduced sexual interest is a separate concern, although the two can occur together.
Has your interest in sex changed too? Explore low libido →The hormonal connection
Testosterone plays a role in sexual function.
Low testosterone can contribute to erection difficulties and reduced sexual desire. Thyroid disorders can also affect sexual function.
An erection also depends on blood vessels and nerves working properly. Hormone testing can therefore be useful, but it is only one part of understanding the problem.
What treatment research shows
The TRAVERSE Sexual Function Study included 1,161 men aged 45–80 with low libido and confirmed low testosterone. Participants also had cardiovascular disease or increased cardiovascular risk.
Compared with placebo, testosterone treatment improved sexual desire and activity.
It did not improve erectile function in that study.
The distinction matters: treating testosterone deficiency may help some aspects of sexual health while erection difficulties still need their own treatment.
Read the study — Journal of Clinical Endocrinology & Metabolism
When testosterone deserves investigation
Changes in desire, spontaneous erections, and energy can help inform the assessment. Diagnosis of testosterone deficiency requires compatible symptoms and consistently low blood levels.
If deficiency is confirmed, your physician considers its cause, treatment suitability, and whether erection-specific care is also needed.
Looking at the whole picture
Blood flow, health, and circumstances all matter.
Blood vessels and nerves
Diabetes, high blood pressure, and other vascular or nerve conditions can affect erections. Your physician considers your wider health alongside the sexual concern.
Medication and lifestyle
Some medicines, smoking, and heavier alcohol use can contribute. Share what you take, including supplements and any erection medication already tried.
Stress and performance pressure
Anxiety, stress, and depression can cause or worsen erection difficulties. Emotional and physical contributors may overlap.
Care with a clear next step
Understand your options.Choose a next step with your physician.
Your physician asks when the changes began, how consistent they are, whether desire has changed, and what you have already tried.
Medical history, a physical examination when needed, and selected tests help guide recommendations.
Treatment depends on the findings
Options may include medication that supports blood flow, addressing a contributing health condition, reviewing existing medicines, or support for anxiety and relationship concerns.
When testosterone deficiency is confirmed, hormonal treatment may be considered as part of the plan. A urology referral or other specialist assessment may be appropriate.
Support beyond the appointment
Your dedicated WhatsApp team helps coordinate appointments, recommended bloodwork, and follow-up in English or Spanish.
Your physician explains the options, considers medication suitability, and reviews how you respond.
Ask our team about current consultation and testing prices before you decide.
Explore sexual health care for men →Questions about erection difficulties
Does erectile dysfunction mean I have low testosterone?
No. Low testosterone can contribute, but erections also depend on blood flow, nerves, and psychological factors. Your physician considers those possibilities together and determines which tests are useful.
Can treatment help if my testosterone is normal?
Yes. Erection-specific treatments and care for other contributing factors may still be appropriate. A normal testosterone result helps guide the assessment; it does not mean there are no treatment options.
Will I automatically be prescribed TRT?
No. Testosterone treatment requires an appropriate clinical indication. Your physician may recommend erection-specific treatment, further investigation, or another approach based on the findings. Explore testosterone replacement therapy →
I still get morning erections. Should I mention that?
Yes. Changes in spontaneous or morning erections are useful information. They help your physician understand the pattern, but their presence or absence cannot establish the cause by itself.
What if I’ve already tried erection medication?
Tell your physician what you used, how you took it, how often you tried it, and whether you noticed benefit or side effects. A review can help clarify the response and whether further investigation or another approach is appropriate.
Can stress affect erections even when I still want sex?
Yes. Stress and anxiety can affect erections despite sexual desire. Physical and psychological contributors may occur together, so assessment should make room for both.
Can I start with an online consultation?
Contact our team to discuss the available arrangements. An initial conversation and review may take place virtually, while your physician determines whether an in-person examination or additional testing is needed.
Do I have to explain everything to the WhatsApp team?
You can start by saying you would like a physician assessment for a sexual health concern. The team helps with arrangements, and you can discuss personal clinical details directly with your physician.
You can bring this up.We’ll help you take the next step.
Start a conversation with our team about arranging a physician assessment. Understand your options and what the process involves before you decide.
English and Spanish support across Colombia.