Erectile Dysfunction & Low Libido

ED is not always hormonal

• vascular causes

• nerve-related causes
   

• medication effects

• psychological factors
   

• relationship strain

• metabolic dysfunction
   

• sleep-related contributors

• hormonal factors in some men
   

Low libido is not always testosterone-driven

• low testosterone in some men

• stress, anxiety, or low mood

• relationship disconnection

• medication effects

• poor sleep

• alcohol or smoking

• obesity or metabolic dysfunction

• prolactin or thyroid issues where relevant

What Dr Rui assesses

• symptom pattern and onset

• libido, erections, ejaculation, orgasm

• relationship context where relevant

• current medications and supplements

• smoking, alcohol, and drug use

• weight, diabetes, and cardiovascular risk

• sleep, stress, and morning erections

• hormones and other bloods where indicated

Possible investigations

• hormone profile where indicated

• glucose, HbA1c, and lipids

• prolactin and thyroid where relevant

• cardiovascular review

• penile Doppler in selected cases

• onward specialist referral where needed

Treatment may involve

• lifestyle and metabolic correction

• PDE5 medication where appropriate

• TRT only when true deficiency exists

• counselling or psychosexual support

• relationship-aware guidance

• onward referral when needed