Low Testosterone (Hypogonadism) as a Cause of Erectile Dysfunction (ED)

by Alex Shteynshlyuger MD

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

What is Low Testosterone?

Hypogonadism or low testosterone levels occur when the body does not produce enough sex hormones to carry out normal physiological or sexual processes in the body.  In men, hypogonadism is caused by low testosterone level which is the male sex hormone. It can lead to infertility or developmental problems in men and a number of other symptoms. Hypogonadism may also occur due to the imbalance between testosterone and estrogen levels.

The most common cause of low testosterone in men is age-related testosterone deficiency.  Testosterone levels tend to decrease slowly as men age.

Low testosterone levels are a common cause of erectile dysfunction in men.  Often, medications such as Viagra or Cialis do not work well in men who have low testosterone levels.  Shockwave therapy for ED works best in men who have normal testosterone levels.  Treatment of low testosterone levels is an important component of treatment in men with erectile dysfunction.

Signs and Symptoms of Low Testosterone Levels in Men

Low T Treatment in NYC

Low testosterone and ED Treatment

Hypogonadism can produce a variety of symptoms, which vary among individuals. Hypogonadism during fetal life can lead to the development of female-like genitalia or poorly developed male sexual organs.

During childhood, low or absent testosterone will prevent the attainment of secondary sexual characteristics, which will be manifest as less muscle mass, long stature, bone weakness, lack of penile growth and lack of pubic hair growth, and high pitched voice.

In adult life, low testosterone levels can cause infertility, development of breasts (gynecomastia or man-boobs), loss of libido and erectile dysfunction. Loss of muscle mass and decreased bone density may also occur.  Malaise and lack of energy can be caused by low testosterone levels, as well as many other causes.

Hypogonadism and Erectile Dysfunction

Hypogonadism can cause erectile dysfunction. It is a very important cause of impotence in males. A low level of testosterone can also cause low libido or decreased sexual desire.

Treatment for Erectile Dysfunction due to Hypogonadism

In order to treat erectile dysfunction caused by low testosterone levels, it is necessary to treat hypogonadism.  In addition to that, treatment for erectile dysfunction with medications such as Viagra and Cialis can be started. Often treatment of low testosterone levels with testosterone replacement therapy (TRT) improves or reverses erectile dysfunction.  Other times, men require treatment of both erectile dysfunction and low testosterone levels.

It is not possible to treat congenital hypogonadism during fetal life (this is a very rare condition).

Hypogonadism that occurs during childhood or adult life can be treated very effectively by addressing the cause, or by hormone replacement therapy.

It is important to know that testosterone replacement therapy with testosterone (cream, gel, injections, pellets, nasal spray) can cause male infertility.  For men who plan to have children, alternative treatment options should be considered.

The diagnosis of low testosterone levels is established by a blood test.    An early morning blood test is advised as it gives the most accurate results. If low testosterone levels are discovered, the test needs to be repeated to confirm the findings.  Testosterone levels fluctuate during the day, with levels highest in the morning and lowest in the evening. They also vary day-to-day.  As a result, low levels need to be repeated to verify that they are truly low.

For secondary hypogonadism, treatment is targeted at the correction of disease in the pituitary and replacement of pituitary hormones that may induce the production of testosterone by testes.

For primary hypogonadism, e.g. in testicular failure, treatment is targeted at the replacement of testosterone in the body. Testosterone replacement therapy is useful in correcting erectile dysfunction and a number of other symptoms associated with low testosterone in adults. In young boys, testosterone replacement therapy is effective in bringing about normal puberty and preventing infertility in later life. Testosterone replacement therapy can be in the form of injection, patch, gel, gum or oral tablets.

In men who are planning to have children, special approach must be undertaken during testosterone replacement therapy (TRT) to avoid suppressing testicular function.

Testosterone Injections are usually safe and effective and given via the intramuscular route. Normally a single shot every two weeks is all that is required for normal blood levels.

Testosterone replacement therapy in the form of a patch or gel can be applied once a day, either on the back, thigh, abdomen or arm.

In men of reproductive age, testosterone replacement can cause infertility. In these men, treatment with medications that stimulate testosterone production instead of giving testosterone is a better option.

Biological Explanation for ED in Men with Hypogonadism

Testosterone is the male sex hormone that is secreted by Leydig cells in the testicles. Testosterone synthesis is controlled by the luteinizing hormone, LH, produced in the pituitary gland. LH is released from the anterior pituitary gland along with follicle-stimulating hormone or FSH. FSH is not responsible for testosterone release but controls the maturation of sperm. Testosterone is responsible for the development of male sexual organs during fetal life. After birth, it plays a major role in the development of secondary sexual characteristics, including hair pattern, deepening of the voice and development of male genitalia. Later on in life, testosterone is responsible for the maintenance of libido, i.e. desire for sex, and thus plays a major role in sexuality.

Hypogonadism may be primary or secondary.  Primary hypogonadism is usually caused by defective synthesis of testosterone or testosterone receptor insensitivity due to a mutation. It may be due to autoimmune disease, infection, tumors, surgery, radiation or congenital diseases such as Klinefelter syndrome.

In secondary hypogonadism, the testosterone biosynthetic machinery is intact, but there may be a defect in the stimulus for the production of testosterone, and this defect is usually linked to a decreased production of FSH and LH.  The problem may originate in the hypothalamus or more commonly in the pituitary gland. The causes of secondary hypogonadism include trauma, tumors, infection, genetic causes or nutritional deficiencies.

Hypogonadism may be present at birth, in which case it is known as congenital hypogonadism.  Congenital hypogonadism may be due to developmental disorders, or it may be due to genetic alterations of the biosynthetic machinery. Acquired hypogonadism is a type that develops later in life, usually during adulthood and can be due to pathology in the hypothalamus and pituitary gland or testicular failure.  Varicocele is another treatable cause of primary hypogonadism.

Where to Get Treatment for ED in NYC?

At New York Urology Specialists, we offer specialized treatment for ED for men. Same-day appointments are available.

Call/text today: 1-646-663-5211 or make an appointment online.  

We treat sexual and erection problems and offer comprehensive STD testing for infections.  We treat penile problems in men, including phimosis, balanitis, penile irritation, and penile redness. We perform a no-scalpel vasectomy, vasectomy reversal, cosmetic circumcision, circumcision revision, penile frenuloplasty. We offer confidential appointments.

Our prices are ED treatment prices are affordable with or without insuranceLow-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.  We offer free insurance verification.

Read Real Stories of Men who Underwent Treatment for ED at New York Urology Specialists.

We offer ED treatment to patients within driving distance to our offices as well as from other states and countries.  Our patients come from New York, New Jersey, Pennsylvania, and Connecticut, and over 30 countries worldwide.

What do Penile Problems Look Like?

You can find pictures of penile problems including before and after treatment images in our image gallery.

What You Need to Know:

Why Choose New York Urology Specialists for Treatment of Erectile Dysfunction?

  • All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
  • We offer diagnostic testing in our office which avoids hospital costs.
  • Extensive Experience: Thousands of men have treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
  • Confidential and Understanding Care. We understand that most of our patients desire privacy.  We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
  • We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
  • We are conveniently located within 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.

Scheduling Appointments for ED Treatment at New York Urology Specialists

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation, and other sexual concerns.  He has successfully treated hundreds of men with sexual problems including ED and poor libido.

Patients Reviews

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by on May 12, 2022

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by on Feb 14, 2021

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solved my problem with ED
by on Jan 29, 2021

Dr. Shteynshlyuger helped to solve my problem with ED

Very Pleased
by on Jan 21, 2021

Very Pleased, I couldn’t have asked for more from Dr. S as well as everyone in the office, The procedure and after was a dream with Dr. S. If you are on the fence, I can tell you, that you will love your experience with Dr. S

by on Jan 11, 2021


treatment from New York Urology
by on Jan 07, 2021

My problem with ED is gone with my treatment from New York Urology!

What went well

Appointment scheduling Office environment Staff friendliness Wait times Appointment wasn't rushed Listened & answered questions Explained conditions well Trusted the provider's decisions

What could be improved

recommend Dr. Shteynshlyuger
by on Jan 04, 2021

Yes I would recommend Dr. Shteynshlyuger . Effective physician at all levels.

I would highly recommend it to anyone
by on Oct 11, 2020

I saw the reviews about this place and was very hesitant to go but something was telling me to go with them and I don't regret it at all, the doctor did a great job and helped me understand the process plus the staff was amazing I would highly recommend it to anyone! quick story after the procedure I was in soo much pain and called the office on a SUNDAY, the doctor gave me a call back within 15 minutes and prescribed a stronger medication, to me that meant a lot for the doctor to take time from his day on a Sunday to help me.

highly qualified diagnostician
by on Sep 23, 2020

I have been observed by Dr. Alex for many years and I must say that he is a highly qualified diagnostician, and also several times I have received qualified microsurgical assistance and very useful advice. The only reason I put 4 with a plus is a somewhat long wait for the reception.

very friendly staff
by on Apr 12, 2020

excellent doctor and all very friendly staff

Doctor Shteynshlyuger provided me with the care I needed
by on Mar 11, 2020

The staff is very professional. Doctor Shteynshlyuger provided me with the care I needed. The wait, visits, and instructions were brief. I followed his instructions and my issue was resolved. As a patient exercise patience. Follow the instructions and be honest about your condition and what you hope to accomplish be visiting. Thanks again Doctor.

Patient review
by on Jan 24, 2020

Shang Ring circumcision
by on Oct 29, 2019

Overall, it was a good experience. Dr. Shteynshlyuger (Dr. Alex) was very nice, warm and helpful. He performed a Shang Ring circumcision for me and the procedure went well. I'm pleased with the results and there were no complications. If anyone is interested in the shang ring circumcision in the tristate area, then I'd recommend him. The whole procedure is $1850, which includes the initial consultation (provided that ther are no complications) and every follow up visit up to six months.

What went well

Appointment scheduling Office environment Staff friendliness Wait times Appointment wasn't rushed Listened & answered questions Explained conditions well Trusted the provider's decisions

What could be improved

Office very convenient location
by on Aug 13, 2019

Office very convenient location Don’t have to wait for long Staff very friendly Dr shteynshyuer very experienced I had my serviced done in 3 visits now I feel good now Than you Dr. shteynhlyuger

Peronis Disease
by on Aug 04, 2019

Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.

3P Removal
by on Jul 24, 2019

Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.

by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Urology Visit
by on Jul 18, 2019

Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.

by on Jul 09, 2019

Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Satisfied Patient
by on Sep 15, 2018

I am very please and satisfied with everything that has been offorded to me by New York Urology Specialist Office.....Dr Alex

Surgical Procedure
by on Sep 01, 2018

Dr Alex and his staff are through professionals in every sense of the word. From initial diagnosis to a period of evaluating and ruling out options, we decided upon a surgical solution, which appears for the most part to have corrected the issue. Thanks to Ana, and the staff, especially Dr. Alex for treating me so well. Best regards, Lee

by on Aug 16, 2018

Outstanding service

A very good doctor
by on Aug 15, 2018

Dr. Alex Shteynshlyugerand is careful, patient, experienced. Uses innovative approaches, that actually yield results. He is indeed a good doctor, in every sense

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by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

My wife was elated
by on Jan 15, 2018

Well I put it to use last night and man, good job. My wife was elated. u made it much better somehow, so thank u for fixing my penis

by on Dec 05, 2017

"Cannot express how thankful I am I found Dr. Shtetnshlyuger. After undergoing surgery to correct a penile torsion I couldn't be happier with the results. A great doctor who is clearly good at what he does. With something as important as your private area, It's nice to be able to rest easy and know you are in good hands.." via HealthGrades.com 12/5/2017

by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

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by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.

ED is Treatable in Nearly Every Man

Excellence-Urology_Care-banner2At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction.  We understand the challenges that ED creates for our patients, their relationships, and their self-esteem.  We help you find a treatment for erectile dysfunction that fits your needs, lifestyle, and your preferences.

Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED.  We offer medical and surgical treatment for erectile dysfunction.

We Treat Some of the Most Complex ED Problems Including:

Schedule an Appointment with Dr. Shteynshlyuger:

Call/text today: 1-646-663-5211 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship-trained board-certified urologist with expertise in the evaluation and treatment of sexual and erection problems in men using modern effective and proven treatment methods.  We offer inflatable penile implant, shockwave therapy for ED, and treatment for Peyronie’s disease.

He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.

If you have any questions, to schedule a consultation, please contact us or call/text: 1-646-663-5211.

We have excellent reviews from patients and their partners.  Information for out-of-state and international patients.  Find out our office hours or directions to our office

We offer affordable appointment prices with or without insurance.  Low-cost Viagra (sildenafil) and Cialis (tadalafil) are available to our patients.

We offer weekday, weekend, and evening office hours.

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