Does Anastrozole Help Erectile Dysfunction?

If you’ve scoured the internet for potential causes of erectile dysfunction, you’re probably aware of conditions like low testosterone that could be killing your game. But there’s actually a whole network of hormones and processes keeping your member operating properly. Estrogen in particular plays an important—and underrated—role in erectile function. 

“While testosterone is often the main focus, having too much or too little estrogen can throw things off,” Joshua Calvert, M.D., explains. And the two sex hormones are related. If your T starts climbing after starting testosterone replacement therapy (TRT), your estrogen follows. Heightened estrogen can cause erectile dysfunction, infertility, man boobs, fatigue, and brain fog.  

To counteract creeping estrogen levels, many doctors will prescribe an aromatase inhibitor like anastrozole alongside TRT. So by that logic, anastrozole should help with erectile dysfunction, right? You’re on the right track, but as Calvert notes, the relationship between hormone therapy and ED is complicated.

About the Experts

Robert Charles Welliver Jr., M.D., is a board-certified urologist with the American Urological Association. He specializes in the treatment of erectile dysfunction and low testosterone.

Joshua Calvert, M.D., is a board-certified urologist and an independent consulting physician for Broad Health, Hone Health’s affiliated medical practice.

Can You Take Anastrozole for Erectile Dysfunction?

There’s a proven connection between high estrogen and erectile dysfunction. One study found that men with ED had higher estrogen than men who didn’t have the condition (1). 

Another study from 2019 in the journal Translational Andrology and Urology found a negative correlation between base erection time (when the base of the penis begins to get hard) and estrogen levels (2). That means the higher the estrogen level, the longer it takes for the base of the penis to start getting hard.

So, if anastrozole can bring down high estrogen levels, can it also improve erectile function? Possibly, doctors say. 

Anastrozole can reduce high estrogen levels, which could help tilt the balance back in favor of testosterone, Calvert explains. “Theoretically, this could improve erectile function by boosting available testosterone, which is crucial for maintaining healthy erectile physiology.”

There isn’t any research exploring anastrozole as a treatment for erectile dysfunction, he notes. But anecdotes from his patients suggest that anastrozole could help a specific subset of guys with ED—those who have high estrogen. 

“In my experience, some patients who had higher estrogen levels have reported improvements in their erectile function when using anastrozole,” he says, adding, “It’s hit or miss. Some men see benefits, but others might not notice a significant change.” 

While estrogen certainly plays a role in erectile function, high estrogen isn’t the only cause of ED. Diabetes, obesity, high blood pressure, injury to the penis or brain, certain medications, and excessive drinking can all make it difficult to stay hard (3). If your ED is caused by something other than high estrogen, anastrozole probably won’t help. 

Can Anastrozole Cause ED?

While too-high estrogen can seemingly weaken your willie, low estrogen can also contribute to erectile dysfunction.

“In some cases, anastrozole and other aromatase inhibitors may be too potent and lower estrogen levels too far,” urologist Robert Welliver, M.D., says. “If your estrogen levels get to be too low, that may actually worsen ED.”

It’s important to keep your estrogen levels carefully balanced in an ideal range—around 10 to 40 pg/ml—to avoid any sexual dysfunction. Which is why anastrozole should be used only as part of a closely monitored hormone therapy treatment. It’s not like Viagra, which you can pop before getting it on. 

ESTROGEN 101

Do I Need to Take Anastrozole with Testosterone?

Yes, Men Need Estrogen. Here’s Why

Anastrozole Side Effects

Like any medication, anastrozole can cause a few side effects as your body adjusts. These include:

• Hot flashes
• Dizziness
• Blurred vision
• Nervousness
• Muscle weakness

These side effects may subside as you get used to the hormone treatment, which can take a few weeks to several months. If the side effects don’t subside, your doctor may adjust your treatment or take you off the medication.

Some doctors also warn that if your treatment isn’t carefully monitored and you develop prolonged low estrogen, you could be at risk for certain long-term side effects—namely, reduced bone density. If your estrogen levels drop below 10 pg/ml, that’s a sign that you may need a lower dose or go off of anastrozole. 

Fast, Easy, Affordable

Hone’s at-home testosterone assessment is the simplest way to uncover whether your levels are low. If you qualify for treatment, TRT can be sent right to your door.  

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A Better Way to Treat ED

Anastrozole isn’t a mainstream or a first-line treatment for erectile dysfunction, Calvert says. But in cases where there’s clear evidence of hormonal imbalance, particularly elevated estrogen, anastrozole might be considered as part of a broader treatment plan.

Welliver agrees, noting that he doesn’t prescribe anastrozole to treat ED alone, but sometimes prescribes it in a hormone therapy protocol for low T.

Instead, Calvert notes, most doctors would start by checking testosterone levels. If your T is low, they’re likely to prescribe more traditional ED treatments such as PDE5 inhibitors (like Viagra or Cialis) before considering something like anastrozole—especially if you don’t have high estrogen or low testosterone.