How Hormones Affect Men’s Sexual Performance: Testosterone, LH, FSH & Prolactin

Hormones play a prime role in men’s sexual health by controlling erectile function, sex drive, and reproductive health. When it comes to male sex hormones, testosterone is the key hormone that is responsible for libido, sperm production, and energy levels. Hormonal imbalances can significantly reduce libido and sexual stamina and cause erectile difficulties.

Learning about your hormonal health and how they influence your sexual performance is crucial for men. In this blog, we will understand how male sex hormones such as testosterone, LH, and FSH affect men’s sexual health.

Testosterone is the key hormone responsible for sexual performance in men; however, it also depends on the balance of LH, FSH, and prolactin. Here are the prime male sex hormones and their functions:

Testosterone is the main sex hormone that is produced in the testes. It drives sexual desire, sperm production, bone density, muscle mass, and energy levels.

LH (Luteinizing Hormone) is produced by the pituitary gland. It stimulates the testes for testosterone production.

FSH is produced by the pituitary gland, and it is responsible for fertility and sperm production.

Dihydrotestosterone is produced by testosterone conversion in tissues. It is responsible for masculine characteristics and prostate health.

Estrogen is derived from testosterone through the enzyme aromatase. Men require small amounts of estrogen for libido, testosterone regulation, and bone health.

Cortisol hormone, also called the stress hormone, is produced by the adrenal glands. High levels can negatively impact sexual performance.

Prolactin is produced by the pituitary gland, and it reduces libido, especially during an elevated period.

Growth hormone is produced by the pituitary gland. It supports energy levels and muscle mass that indirectly affect sexual performance.

Insulin is produced by the pancreas, and it regulates blood sugar levels. Imbalanced levels influence mood, energy, and sexual function.

• Testosterone (Drives sexual desire in men)

• Dihydrotestosterone (Supports sexual desire)

• Estrogen (Controls testosterone levels)

• Prolactin (reduces elevated libido)

• Testosterone (supports erectile mechanisms)

• DHT (penile sensitivity and erectile tissue function)

• Estrogen (improves blood flow to the penis)

• Cortisol (elevated levels can disturb erectile function)

• FSH (regulates sperm production)

• LH (controls testosterone production)

• Testosterone (sperm maturation)

• Testosterone (sexual desire)

• DHT (sexual sensitivity and responsiveness)

• Prolactin (libido regulation)

• Growth Hormone (overall sexual activity)

Check out the table mentioned below for a clearer picture of male sex hormones and their functions:

The male reproductive system primarily involves testosterone, FSH, LH, and DHT. These hormones are responsible for male characteristics, sexual function, and fertility. Other hormones, including prolactin, estrogen, and cortisol, are responsible for arousal and overall sexual and reproductive health.

It is the main sex hormone in men that is responsible for sexual desire, erections, and sperm production. It is also responsible for male sexual characteristics (deep voice, facial hair, and muscle mass).

It is an effective androgen that is responsible for the development of sexual characteristics and male genitalia. DHT is also responsible for penile sensitivity, libido, and prostate health.

It stimulates the testes to produce testosterone. Testosterone production reduces without adequate LH, which can diminish erectile function, libido, and sperm production.

It helps stimulate sperm production and is essential for fertility.

Although it’s a female hormone, it is vital for males as well. It supports bone health, erectile function, and libido.

It controls reproductive function and sexual satisfaction. Higher levels can suppress libido and sexual arousal.

High levels of stress hormone (cortisol) can reduce testosterone production and sexual desire.

It regulates stamina, energy, and overall vitality that indirectly support overall sexual and reproductive health.

Testosterone is primarily responsible for sexual desire, erection, and arousal. It increases the penile sensitivity and incites sexual feelings that are crucial for erections. Nitric oxide is the main chemical that enables erections, and it is produced by endothelial cells. The testosterone hormone increases the production of nitric oxide in the penile tissue, which allows proper blood flow into the penis and relaxes blood vessels.

Erectile dysfunction can be closely associated with hormonal imbalance. Hormonal imbalance can be the prime reason for erectile dysfunction because hormones control blood flow, erectile tissue function, and libido (sex drive).

The key hormones associated with erectile dysfunction are:

• Testosterone: Reduced levels impair erections and reduce libido.

• Dihydrotestosterone: Reduced levels influence penile sensitivity.

• Prolactin: High levels can reduce libido and arousal.

• Thyroid hormone: An underactive or Overactive thyroid is responsible for erectile dysfunction.

• Cortisol: high levels reduce testosterone levels and impair erections.

• Testosterone (total and free)

• LH and FSH (testicular function)

• Prolactin

• Thyroid hormones

• Estradiol

Too much production of testosterone may also lead to erectile dysfunction when caused by steroids / TRT misuse. High levels can boost aromatization, which increases estradiol and affects libido. It can cause hormonal signaling problems, which in turn reduce sperm production.

Here’s the table showing hormonal levels associated with erectile dysfunction:

Here are the tests that help detect hormonal issues in men:

It measures testosterone levels in the blood, including free testosterone levels and total testosterone. Typically, it's done in the morning as testosterone is at peak levels during the morning.

It assesses LH levels from the pituitary glands that control testosterone production. Imbalance affects sexual function.

It measures FSH levels from the pituitary gland, which is responsible for sperm production. Imbalances or elevated FSH levels may contribute to fertility issues.

Moreover, testosterone, FSH, and LH tests are combined to detect low testosterone and the causes of infertility.

Here’s the table demonstrating normal ranges of these hormones in adult males:

LH and FSH are among the crucial male sex hormones, and low levels can cause various problems. Usually indicates secondary hypogonadism; testosterone may be “normal” temporarily due to diurnal effect, but the underlying pathology should be emphasized. Here are the low LH and FSH in males symptoms and what causes low levels:

• Reduced sex drive

• Erectile dysfunction

• Reduced sperm production

• Infertility concerns

• Low energy and lethargy

• Reduced strength and muscle mass

• Less facial hair

• Mood changes or depression

• Pituitary gland disorders

• Hypothalamic dysfunction

• Chronic illness

• Certain medications

• Genetic diseases

• High cortisol or persistent stress

High levels are generally associated with testicular dysfunction, low testosterone, and reduced fertility. This is rare; usually suggests compensated primary testicular dysfunction.

• Infertility problems

• Reduced testosterone

• Mood change

• Reduced muscle mass

• Decreased strength

• Genetic conditions

• Chemotherapy

• Testicular infection, injury, or surgery

• Aging-related decline

• Chronic testicular damage

High levels typically indicate primary hypogonadism. Here are the treatment approaches:

• Testosterone therapy helps males with low testosterone levels.

• Restores erectile function, sexual desire, energy, and mood.

• Can be given through testosterone gels, patches, injections, and implants.

• Fertility-related treatment includes Human Chorionic Gonadotropin (hCG), which stimulates testosterone production.

• Also given FSH injections to stimulate sperm production.

• Healthy diet and exercise plan

• Stress management techniques

• Limiting smoking and excessive alcohol consumption

• Avoid anabolic steroid consumption.

Here’s how you can increase LH and FSH levels in men:

• Treating Underlying Causes such as medications, chronic illness, and pituitary disorders.

• Maintaining a healthy body weight can restore hormone levels.

• Prioritizing 8 hours of sleep.

• Managing your stress levels through mindfulness.

• Regular aerobic and resistance exercises.

• Medical therapies include pulsatile GnRH Therapy, human chorionic gonadotropin injections, and recombinant FSH therapy.

Abnormal hormonal levels in men can directly cause sexual health issues. If you are experiencing persistent erectile dysfunction and difficulty with erections or fertility problems, you should check with your doctor. In case of hormonal imbalances such as high or low testosterone, LH, or FSH, you should seek professional advice from your healthcare provider. Early evaluations allow better treatment outcomes.

***Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphics, and images, is intended as a substitute for professional medical advice. Please consult with your doctor about specific medical advice about your condition(s).