From the Guidelines
To investigate erectile dysfunction, blood tests such as fasting glucose or HbA1c, lipid profile, testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, thyroid function tests, and complete blood count are recommended. These tests are essential to identify potential underlying causes of erectile dysfunction, including diabetes, cardiovascular disease, hormonal imbalances, and thyroid disorders 1.
Key Blood Tests
- Fasting glucose or HbA1c to check for diabetes
- Lipid profile to assess cholesterol levels
- Testosterone (total and free) to evaluate hormonal status
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to assess pituitary function
- Prolactin to rule out hyperprolactinemia
- Thyroid function tests (TSH, T3, T4) to check for thyroid disorders
- Complete blood count to screen for anemia Additional tests may include prostate-specific antigen (PSA) for men over 40 to assess prostate health, and in some cases, more specialized hormonal tests like estradiol or sex hormone-binding globulin (SHBG) 1.
Importance of Testing
Testing should be done in the morning when hormone levels, particularly testosterone, are at their highest for the most accurate results 1. The American College of Physicians does not recommend for or against routine use of hormonal blood tests or hormonal treatment in the management of patients with erectile dysfunction due to insufficient evidence to determine net benefits and harms 1.
Clinical Considerations
Erectile dysfunction may be caused by chronic diseases, such as obesity, hypertension, dyslipidemia, and cardiovascular disease, or smoking; medications; psychosocial factors; and hormonal abnormalities 1. Clinicians should individualize decisions to measure hormone levels based on the clinical presentation and physical findings that suggest hormonal abnormality.
From the Research
Blood Tests for Erectile Dysfunction
The following blood tests are recommended to investigate erectile dysfunction:
- Fasting serum glucose level 2, 3, 4, 5
- Lipid panel 2, 3, 4, 5
- Thyroid-stimulating hormone test 2, 4, 5
- Morning total testosterone level 2, 3, 6, 4, 5
- Prolactin level 6, 4, 5
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) tests may be necessary if testosterone levels are low 6
- Prostate-specific antigen test may be considered in select cases 3, 4
- Hemoglobin A(Ic) and total serum cholesterol levels may be useful in identifying risk factors for erectile dysfunction 4
- Hemoglobin and creatinine levels may be useful in identifying anemia and renal insufficiency 4
Rationale for Blood Tests
These blood tests can help identify underlying medical conditions that may be contributing to erectile dysfunction, such as: