PCOS Hormone Panel
A targeted nine-marker hormonal and metabolic screen designed to assess the key features of polycystic ovary syndrome — including androgens.
£109.00
View test
Overview
What Is Erectile Dysfunction?
Erectile dysfunction (ED) — defined as the consistent or recurrent inability to achieve or maintain an erection sufficient for satisfactory sexual intercourse — affects an estimated one in five men in the UK at any given time. While psychological factors are frequently cited as a cause, research consistently shows that the majority of men with persistent ED have a measurable physical driver — and in many cases, a correctable one identifiable through targeted blood testing.
Testosterone is the primary androgen governing male sexual function. Low testosterone — assessed via total testosterone and SHBG — reduces both libido and the vascular response required for erection. Crucially, total testosterone can appear normal while free (biologically active) testosterone is low if SHBG is elevated, which is why both markers must be assessed together. LH and FSH from the pituitary distinguish testicular failure from hypothalamic suppression — an important distinction for determining the most appropriate treatment pathway.
Metabolic health is equally central. Type 2 diabetes and insulin resistance — assessed via HbA1c — cause erectile dysfunction through two distinct mechanisms: endothelial dysfunction impairing penile arterial vasodilation, and autonomic neuropathy disrupting the nerve signals required for erection. Hypothyroidism reduces testosterone production and impairs vascular reactivity. Elevated CRP and systemic inflammation predict cardiovascular endothelial function — and ED is increasingly recognised as an early marker of cardiovascular risk. A comprehensive male hormone and metabolic panel addresses all of these dimensions simultaneously.
Erectile Dysfunction vs. Psychological Causes
Physical and psychological causes of erectile dysfunction commonly co-exist and reinforce each other — performance anxiety exacerbates hormonally driven ED, while chronic ED caused by low testosterone or metabolic dysfunction inevitably generates psychological distress. Blood tests identify the treatable physical contributors — including hormonal, metabolic, and inflammatory factors — that psychological therapy alone cannot address. Treating the physical cause frequently resolves the psychological component simultaneously.
Related experience
Common Symptoms Associated With Erectile Dysfunction
Erectile dysfunction caused by hormonal or metabolic imbalance is typically accompanied by other systemic symptoms that reinforce the underlying diagnosis.
Low Libido
Low testosterone drives both reduced sexual desire and impaired erectile function through the same androgen-dependent pathway.
Fatigue
Low testosterone and thyroid dysfunction cause profound fatigue that reduces both sexual motivation and physical capacity.
Brain Fog
Testosterone, thyroid hormones, and glucose regulation all govern cognitive clarity — impairment in any affects mental sharpness alongside sexual function.
Muscle Weakness
Testosterone deficiency reduces muscle protein synthesis — men with ED from low testosterone frequently report reduced physical strength and muscle mass.
Poor Sleep
Testosterone production peaks during sleep; chronic sleep disturbance suppresses testosterone, creating a reinforcing cycle of low androgen and poor sleep.
Low Motivation
Testosterone has direct neurological effects on drive and motivation — deficiency produces a global reduction in energy, initiative, and libido simultaneously.
The big picture
What Causes Erectile Dysfunction?
Erectile dysfunction results from disruption of the hormonal signals, vascular function, or neurological pathways required for normal erectile physiology.
What to measure
Biomarkers Associated With Erectile Dysfunction
A comprehensive male hormone and metabolic panel addresses the key physiological drivers of erectile dysfunction in a single blood draw.
Total Testosterone
The primary androgen governing libido and erectile function — low total testosterone is the most common correctable hormonal cause of ED in men over 35.
SHBG
Sex hormone-binding globulin determines how much testosterone is biologically active — elevated SHBG can produce functional testosterone deficiency even when total testosterone appears normal.
LH
Luteinising hormone from the pituitary drives testicular testosterone production — low LH points to central (hypothalamic) suppression, while elevated LH suggests testicular failure.
FSH
Follicle-stimulating hormone works in concert with LH to assess pituitary-gonadal axis integrity and testicular function.
Oestradiol
Excess oestradiol — often arising from aromatisation of testosterone in adipose tissue — suppresses libido and can contribute to ED independently of testosterone levels.
DHEA-S
A marker of adrenal androgen reserve — low DHEA-S indicates reduced adrenal precursor production, which can compound testicular testosterone deficiency.
TSH
Thyroid screening identifies hypothyroidism, which reduces testosterone availability and impairs the vascular response necessary for erection.
HbA1c
HbA1c reflects average blood glucose over three months — raised levels confirm chronic glucose dysregulation damaging penile vasculature and autonomic nerves.
Underlying causes
Conditions Associated With Erectile Dysfunction
These conditions are among the most common identifiable physical causes of erectile dysfunction in UK men.
Low Testosterone
Testosterone deficiency impairs both the central drive for sexual activity and the peripheral vascular mechanisms that produce and sustain erection.
Type 2 Diabetes
Chronic hyperglycaemia damages penile endothelial function and autonomic innervation — ED affects approximately 50% of men with diabetes within a decade of diagnosis.
Hypothyroidism
Low thyroid hormone output reduces testosterone production and impairs vascular smooth muscle relaxation — both required for normal erectile function.
Adrenal Dysfunction
Dysregulated cortisol suppresses the hypothalamic-pituitary-gonadal axis at its highest level, reducing LH and therefore testosterone production.
Insulin Resistance
Insulin resistance precedes type 2 diabetes and independently impairs endothelial function — early identification allows intervention before irreversible vascular changes occur.
Getting answers
How Erectile Dysfunction Is Investigated
A structured investigation of erectile dysfunction prioritises the hormonal and metabolic markers most likely to identify a correctable cause.
1
Step 1 — Male Hormone Profile
Total testosterone, SHBG, LH, and FSH form the core hormonal evaluation. SHBG is critical — high SHBG reduces biologically active testosterone and is common in older men and those with liver or thyroid dysfunction. LH and FSH distinguish testicular from pituitary causes, directing the most appropriate treatment.
2
Step 2 — Oestradiol & Adrenal Androgens
Oestradiol and DHEA-S assess hormonal balance beyond testosterone alone. Elevated oestradiol from aromatisation in adipose tissue suppresses the pituitary-gonadal axis and reduces libido independently of testosterone levels — addressing this is a key component of a complete male hormone assessment.
3
Step 3 — Metabolic & Glucose Markers
HbA1c and fasting glucose identify insulin resistance and type 2 diabetes — the leading metabolic causes of endothelial dysfunction and vascular ED. Early identification allows lifestyle and pharmacological intervention that may prevent progressive vascular damage.
4
Step 4 — Thyroid Function & Inflammation
TSH and CRP complete the assessment. Thyroid dysfunction and systemic inflammation independently impair testosterone metabolism and penile vascular reactivity — both are easily treated once identified and are important components of a comprehensive ED blood panel.
Recommended testing
Recommended Blood Tests
Private blood tests analysed by UK-accredited laboratories.
Adrenal and Stress Hormone Panel
A five-marker adrenal and stress hormone panel measuring cortisol, DHEAS, DHEA, aldosterone, and ACTH — designed for those investigating HPA axis function.
£129.00
View test
Perimenopause Hormone Check
A six-marker hormone panel measuring FSH, LH, oestradiol, progesterone, testosterone, and AMH.
£109.00
View test
Male Hormone and Performance Panel
A focused panel measuring testosterone, SHBG, oestradiol, prolactin, thyroid function, HbA1c, and fasting glucose.
£99.00
View test
Comprehensive Hormone and Wellbeing Panel
A 20-marker comprehensive hormone and wellbeing panel covering sex hormones, adrenal markers, thyroid function, metabolic indicators.
£249.00
View test
Advanced Health and Wellness Panel
A 28-biomarker advanced panel covering full blood count, thyroid (TSH, FT4), extended liver and kidney function, full cholesterol, HbA1c, iron status, and CRP.
£139.00
View test
Everyday contributors
Lifestyle Factors That Can Contribute
Evidence-based lifestyle modifications improve endothelial function, testosterone levels, and erectile performance — and are most effective when guided by blood test results.
Resistance Training
Weight-bearing exercise directly stimulates testosterone production and improves insulin sensitivity — both of which reduce metabolic and hormonal causes of ED.
Reduce Alcohol Consumption
Chronic alcohol intake suppresses testosterone production and impairs the penile vascular response to arousal — reduction measurably improves erectile function in most men.
Achieve & Maintain Healthy Weight
Adipose tissue aromatises testosterone to oestrogen — weight loss in overweight men reliably raises free testosterone and improves erectile function without medication.
Optimise Sleep Quality
Testosterone production peaks during deep sleep — chronic sleep restriction of five hours or fewer reduces testosterone by 10–15% in young men within one week.
Manage Chronic Stress
Sustained cortisol elevation suppresses LH and reduces testosterone production — structured stress management through exercise, mindfulness, or therapy addresses a key physiological driver.
Follow a Mediterranean-Style Diet
A diet rich in vegetables, olive oil, fish, and legumes improves endothelial function and insulin sensitivity — both of which directly support erectile vascular health.
Safety first
When To Seek Medical Advice
While erectile dysfunction is rarely dangerous in itself, certain accompanying symptoms require urgent medical assessment.
Red flags — speak to a doctor
These can point to a more serious underlying cause and should not be ignored.
- Erectile dysfunction accompanied by chest pain on exertion — may indicate significant coronary artery disease; seek urgent cardiovascular assessment.
- ED with marked testicular pain, swelling, or a palpable mass — warrants same-day urological evaluation to exclude testicular pathology.
- Sudden-onset complete erectile dysfunction in a man under 40 — may indicate a significant pituitary or neurological cause requiring imaging.
- ED with marked fatigue, weight gain, and cold intolerance — this triad strongly suggests hypothyroidism and warrants urgent thyroid function testing.
Common questions
Frequently Asked Questions
Yes — low testosterone is one of the most common physical causes of erectile dysfunction, particularly in men over 35. Testosterone drives both sexual desire and the vascular response required for erection. However, total testosterone alone can be misleading — SHBG (sex hormone-binding globulin) determines how much testosterone is biologically active, and elevated SHBG can create functional deficiency even when total testosterone appears normal. Both markers should be assessed together.
Type 2 diabetes is one of the leading physical causes of erectile dysfunction. Chronically elevated blood glucose — reflected by HbA1c — damages the endothelial cells lining penile blood vessels and impairs the autonomic nerves required to initiate erection. ED affects an estimated 50% of men with diabetes within ten years of diagnosis. Early identification of insulin resistance through blood testing allows lifestyle intervention before irreversible vascular damage occurs.
A comprehensive ED blood panel should include: total testosterone, SHBG, LH, FSH, oestradiol, DHEA-S, TSH, HbA1c, and CRP. Together these markers cover the hormonal, metabolic, thyroid, and inflammatory dimensions of erectile function — identifying the specific driver so treatment can be precisely targeted.
Yes — both hypothyroidism and hyperthyroidism are associated with erectile dysfunction. Hypothyroidism reduces testosterone production and impairs penile vascular smooth muscle relaxation. It is among the most commonly overlooked causes of ED and is easily identified and treated. A TSH blood test should be included in any comprehensive male sexual health assessment.
ED is increasingly recognised as an early marker of generalised cardiovascular disease. The penile arteries are smaller than the coronary arteries and become symptomatic from atherosclerosis earlier — meaning ED can precede symptomatic heart disease by three to five years. Elevated CRP, high HbA1c, and lipid abnormalities identified on a blood panel signal cardiovascular risk that warrants treatment beyond managing the ED itself. Men with ED should have a cardiovascular risk assessment as part of their investigation.
Keep exploring
Related Symptoms
Related Biomarkers
Related Conditions
Sources
References
-
British Society for Sexual Medicine — View source
-
European Urology — View source
-
NICE Clinical Knowledge Summaries — View source
This page is for general information only and does not replace personalised medical advice. If you are worried about your health, please speak to a qualified healthcare professional. Trupoint Health blood tests are analysed by UK-accredited laboratories.