If my testosterone is normal, can hormones still be the issue?

Yes. Total testosterone can sit in the normal range while prolactin is elevated or estradiol is off the normal band — both independently drive ED. That is the entire reason the panel includes those markers rather than testosterone alone.

Should I just start sildenafil and skip the testing?

If the goal is short-term function, PDE5 inhibitors are effective for most men. If the goal is finding the cause — especially because ED in men under 60 is one of the earliest signals of cardiovascular disease — testing first is the more thorough move. The two aren't mutually exclusive.

Does this panel diagnose vascular ED?

No. The panel measures hormones. Vascular ED is diagnosed via cardiovascular risk assessment, sometimes penile Doppler ultrasound, and clinical history. We're the fast first step, not the whole workup.

How fast can the result actually change my situation?

If the result flags hyperprolactinaemia and the cause is medication-driven, a clinician can sometimes adjust the medication and see improvement within weeks. If the result flags low free T from high SHBG, that's a different (longer) conversation. If the result is hormonally clear, you redirect your time to cardiovascular workup with a clinician.

← All symptoms◆ Erectile issues

Erectile issues: what a hormone panel can rule in and out

Erectile difficulty in men under 60 is most commonly vascular (blood-flow), psychological, or medication-related. Hormonal causes — low testosterone, elevated prolactin, out-of-range estradiol — account for a smaller but reversible share. A six-marker panel rules the hormonal piece in or out within a week, redirecting the workup either toward endocrine follow-up or toward cardiovascular and psychological assessment. The Hormone Panel 01 does not measure cardiovascular risk markers and is not a diagnosis; it is the fastest single step in the standard workup.

ED is rarely just hormones, but hormones are the fastest piece to rule out.

Order the panel →Take the 2-min quiz

Who this page is for

Men with persistent erectile difficulty — not a one-off, and not 'sometimes' — looking for a structured way to start the workup without committing to a long clinic process upfront.

What's actually happening

An erection requires the right neural signal, intact pelvic vasculature, smooth-muscle relaxation in the corpora cavernosa, and adequate androgen tone at receptor level. Most ED in men under 60 is vascular at root — endothelial dysfunction is often the earliest visible sign of broader cardiovascular disease, which is why ED is taken seriously even when it presents in isolation. Hormonal contributors enter the picture through low free testosterone (libido, central drive), elevated prolactin (axis suppression), and estradiol extremes (mood + libido + receptor dynamics). The hormonal piece is testable in 3–5 days. The vascular piece needs blood-pressure measurement, fasting glucose and a cardiovascular risk discussion with a clinician.

Which markers explain it

TTestosterone
Total + free testosterone. Low T contributes to ED mainly via libido and central drive rather than direct vascular effect — meaning men with low T plus ED often have a second cause stacked on top. Treat T deficiency where it exists, but expect partial improvement.
Read the Testosterone brief →
SHBGSex hormone-binding globulin
Needed to interpret the testosterone number. A normal total with very high SHBG can leave free T inadequate; a normal total with low SHBG (typical in insulin resistance) is sometimes the first signal of an underlying metabolic problem driving the ED itself.
Read the SHBG brief →
PRLProlactin
Persistent hyperprolactinaemia is the textbook reversible hormonal cause of ED. Prolactin-secreting pituitary adenomas, some antipsychotics, SSRIs and opioids are the most common drivers. Treating the prolactin often restores function without needing testosterone replacement.
Read the Prolactin brief →
E2Estradiol
High estradiol in men with elevated body fat or on high-dose testosterone shows up as ED with water retention, mood changes and gynaecomastia. Very low estradiol — most often from aggressive aromatase-inhibitor use — independently impairs erectile function in addition to libido.
Read the Estradiol brief →

What to do next

Order the panel as the first quick step, but in parallel: measure blood pressure (a normal cuff at home is fine), check fasting glucose at your GP, and review every medication you take. If the panel comes back hormonally clear, you've spent a week and €89 to redirect the workup toward the larger vascular and psychological territory — which is exactly the right next move.

When this is bigger than a kit

!Sudden, complete onset ED — possible vascular event, requires same-day medical attention.
!ED with calf pain, claudication, or chest pain on exertion — cardiovascular evaluation is urgent.
!ED with peripheral vision changes or persistent headache — possible prolactinoma, needs imaging.
!ED with priapism episodes (erections > 4 hours) — emergency, irrespective of cause.

FAQ

Common questions before testing.

Order the Hormone Panel 01.

All six markers, one finger-prick, ISO-certified German lab. Physician review and a plain-language report in 3–5 working days.

Order the panel →Take the 2-min quiz

This page is informational and not a medical diagnosis. The Hormone Panel 01 is a screening test. For symptoms or out-of-range results, consult a licensed physician.