Many men prescribed Testogel (testosterone gel) for confirmed testosterone deficiency wonder whether improvements in erectile function will be sustained long-term. Testogel is a transdermal hormone replacement therapy licensed in the UK for treating hypogonadism in adult men. When used appropriately under medical supervision, it restores serum testosterone to physiological levels, which can support erectile capacity alongside libido and overall sexual health. However, the duration and consistency of these benefits depend on continued correct use, regular monitoring, and management of other health factors. This article examines how Testogel affects erectile function, what influences long-term results, and how to maintain benefits safely.
Summary: Erectile benefits from Testogel persist as long as treatment continues correctly and therapeutic testosterone levels are maintained, typically requiring consistent daily application and regular medical monitoring.
- Testogel is a transdermal testosterone replacement therapy licensed in the UK only for confirmed hypogonadism, not for erectile dysfunction in men with normal testosterone levels.
- Steady-state testosterone levels are achieved within two to three days of daily application, with erectile improvements typically noticeable between three to six months.
- Long-term efficacy requires correct application technique, consistent adherence, regular blood monitoring (testosterone, haematocrit, PSA), and prostate surveillance.
- Cardiovascular health, lifestyle factors (smoking, alcohol, exercise, weight), concurrent medications, and psychological factors significantly influence erectile function outcomes.
- If haematocrit exceeds 0.54, treatment must be stopped or adjusted; abnormal PSA or prostate findings require urgent referral via cancer pathways.
- Side effects should be reported to your doctor or via the MHRA Yellow Card Scheme; seek urgent medical attention for chest pain, breathlessness, or prolonged erections.
Table of Contents
Am I eligible for weight loss injections?
Find out whether you might be eligible!
Answer a few quick questions to see whether you may be suitable for prescription weight loss injections (like Wegovy® or Mounjaro®).
- No commitment — just a quick suitability check
- Takes about 1 minute to complete
How Testogel Affects Erectile Function
Testogel (testosterone gel) is a transdermal hormone replacement therapy licensed in the UK for treating confirmed testosterone deficiency (hypogonadism) in adult men. The gel delivers exogenous testosterone through the skin, gradually restoring serum testosterone levels to the normal physiological range. Testosterone plays a crucial role in male sexual function, influencing libido, erectile capacity, and overall sexual satisfaction.
The mechanism by which testosterone supports erectile function is multifactorial. Testosterone receptors are present in penile tissue, including the corpus cavernosum and endothelial cells lining blood vessels. Adequate testosterone levels help maintain nitric oxide synthase activity, which is essential for the relaxation of smooth muscle in penile arteries during arousal. This vasodilation allows increased blood flow into the erectile chambers, producing and sustaining an erection. Additionally, testosterone influences central nervous system pathways that regulate sexual desire and arousal.
It is important to note that testosterone replacement therapy, including Testogel, is not a treatment for erectile dysfunction (ED) in men with normal testosterone levels. NICE Clinical Knowledge Summaries and professional guidelines (such as those from the British Society for Sexual Medicine) emphasise that testosterone therapy should only be prescribed following confirmed biochemical hypogonadism—typically two early-morning serum testosterone measurements below the reference range—accompanied by relevant symptoms. Men experiencing erectile difficulties with normal testosterone levels require alternative investigation and management, as ED often results from vascular, neurological, psychological, or medication-related factors rather than hormonal deficiency. In such cases, lifestyle measures, medication review, and phosphodiesterase type 5 (PDE5) inhibitors are usually first-line treatments, with referral as indicated.
Before starting Testogel, your doctor must exclude contraindications, including known or suspected prostate or male breast cancer, and severe cardiac, hepatic, or renal insufficiency. Prostate assessment (PSA blood test and/or digital rectal examination as appropriate) is required before initiation. Additionally, testosterone replacement suppresses sperm production and is not suitable for men trying to conceive; specialist advice is needed if fertility is a concern.
When appropriately prescribed for genuine testosterone deficiency, Testogel may improve erectile function as part of broader improvements in sexual health, energy levels, and wellbeing. However, individual responses vary considerably, and realistic expectations should be established at treatment initiation.
Duration of Erectile Benefits with Testosterone Gel
The duration of erectile benefits with Testogel depends primarily on continued appropriate use and maintenance of therapeutic testosterone levels. Unlike oral medications for erectile dysfunction that provide acute, time-limited effects, testosterone replacement therapy works by restoring baseline hormonal status. Steady-state testosterone levels are typically achieved within two to three days of daily application. Once therapeutic levels are reached and maintained—usually confirmed at follow-up blood tests—the benefits should persist as long as treatment continues and testosterone levels remain within the therapeutic range.
Clinical studies examining testosterone replacement therapy generally demonstrate sustained improvements in sexual function parameters over extended treatment periods, ranging from months to years. However, these studies typically assess men with confirmed hypogonadism, and the magnitude of benefit correlates with baseline testosterone levels and symptom severity. Men with more profound deficiency often experience more noticeable improvements.
Long-term efficacy requires consistent daily application of Testogel as prescribed. The gel must be applied to clean, dry, intact skin. Application sites differ by product strength: Testogel 1% (50 mg/5 g sachets) may be applied to shoulders, upper arms, or abdomen, whilst Testogel 16.2 mg/g (pump dispenser) should be applied to shoulders and upper arms only. After application, allow the gel to dry fully before dressing. Wash your hands immediately after use. To prevent transfer of testosterone to others, cover the application site with clothing once dry, and avoid showering or swimming for at least six hours (for Testogel 1%) or at least two hours (for Testogel 16.2 mg/g). If close skin contact is anticipated, wash the application site beforehand. Irregular application or inadequate absorption can result in subtherapeutic testosterone levels, potentially diminishing any erectile benefits.
Serum testosterone monitoring is essential. NICE Clinical Knowledge Summaries recommend checking levels at three to six months after initiation, then annually thereafter, with dose adjustments made based on both biochemical results and clinical response.
There is no evidence that physiological testosterone replacement loses effectiveness over time in men who maintain therapeutic hormone levels. However, age-related vascular changes, comorbidities (such as diabetes or cardiovascular disease), and other factors may independently affect erectile function regardless of testosterone status. Regular medical review allows clinicians to distinguish between inadequate testosterone replacement and other causes of sexual dysfunction requiring different management approaches.
Factors That Influence Long-Term Results
Multiple factors influence the long-term effectiveness of Testogel on erectile function, extending beyond simple testosterone level restoration. Baseline health status plays a crucial role—men with significant cardiovascular disease, diabetes mellitus, obesity, or metabolic syndrome may experience less pronounced improvements in erectile function despite adequate testosterone replacement. These conditions independently impair vascular and neurological mechanisms essential for normal erections.
Application technique and adherence significantly impact treatment outcomes. Testogel must be applied correctly to ensure consistent absorption. Common errors include applying to inappropriate sites (check your product's instructions), insufficient drying time before dressing, washing the application site too soon after use, or allowing direct skin-to-skin contact with partners or children before the gel has dried. Risk of testosterone transfer: If testosterone is transferred to women or children through skin contact, it can cause unwanted effects such as virilisation (development of male characteristics). Always cover the application site with clothing once dry, wash your hands after application, and wash the site before anticipated close contact. If a partner or child is accidentally exposed, wash the affected area immediately with soap and water. Poor adherence—missing doses or inconsistent application timing—results in fluctuating testosterone levels that may not provide sustained benefits.
Lifestyle factors substantially influence erectile function independently of testosterone status. Smoking damages vascular endothelium and impairs blood flow throughout the body, including penile arteries. Excessive alcohol consumption, physical inactivity, poor diet, and inadequate sleep all negatively affect sexual function. Men using Testogel should be counselled that optimising these modifiable factors enhances treatment effectiveness.
Concurrent medications may affect erectile function. Antihypertensives (particularly beta-blockers and thiazide diuretics), antidepressants (especially SSRIs), antipsychotics, 5-alpha reductase inhibitors, anti-androgens, opioids, and certain other medications can impair erectile capacity. A comprehensive medication review should be conducted if erectile function does not improve adequately despite therapeutic testosterone levels.
Additionally, psychological factors—including depression, anxiety, relationship difficulties, and performance anxiety—significantly influence sexual function and may require specific psychological or psychiatric intervention alongside hormone replacement. Testosterone therapy alone cannot address these complex psychosocial dimensions of sexual health.
When to Expect Changes in Sexual Function
The timeline for experiencing changes in sexual function with Testogel follows a predictable but variable pattern. Different aspects of sexual health respond at different rates to testosterone replacement. Understanding this timeline helps establish realistic expectations and reduces premature discontinuation due to perceived treatment failure.
Libido (sexual desire) typically responds earliest, often within three to six weeks of initiating treatment. Many men report increased interest in sexual activity and more frequent spontaneous sexual thoughts during this initial period. This relatively rapid response reflects testosterone's direct effects on central nervous system pathways regulating sexual motivation.
Erectile function improvements generally manifest more gradually, typically becoming noticeable between three to six months after starting Testogel. This delayed response reflects the time required for testosterone to exert structural and functional changes in penile tissue, including effects on nitric oxide pathways, smooth muscle function, and vascular responsiveness. Some men report earlier improvements, whilst others require longer treatment duration before noticing significant changes.
Maximum benefits are usually achieved after six to twelve months of consistent treatment with therapeutic testosterone levels. NICE Clinical Knowledge Summaries suggest that if no improvement in symptoms occurs after this timeframe despite confirmed adequate testosterone levels, alternative diagnoses or contributing factors should be reconsidered.
It is important to emphasise that individual variation is substantial. Factors including age, severity of initial testosterone deficiency, presence of comorbidities, and baseline erectile function all influence response timing. Even with therapeutic testosterone levels, erectile function may remain suboptimal in some men due to vascular, neurological, or psychological factors. In such cases, PDE5 inhibitors (such as sildenafil) may be considered alongside testosterone replacement, and further assessment for underlying causes is warranted.
Men should be advised to continue treatment as prescribed and attend scheduled follow-up appointments for testosterone level monitoring and clinical assessment. If erectile function does not improve as expected, further investigation may be warranted to identify other contributing factors requiring specific intervention.
Maintaining Erectile Strength on Testogel Treatment
Sustaining erectile benefits with Testogel requires a comprehensive approach extending beyond simply applying the gel daily. Regular monitoring forms the cornerstone of successful long-term treatment. Men should attend scheduled follow-up appointments for serum testosterone measurement, typically at three to six months initially, then annually. These appointments also provide opportunity to assess treatment response, screen for adverse effects, and adjust dosing if necessary.
Blood monitoring includes full blood count to check for polycythaemia (elevated red blood cell count and haematocrit). If your haematocrit rises above 0.54, your doctor will stop or adjust your Testogel dose and investigate further; specialist advice and venesection (blood removal) may be required. Elevated haematocrit increases cardiovascular risk. Prostate monitoring is also important: baseline PSA (prostate-specific antigen) and digital rectal examination (as appropriate) are performed before starting treatment. PSA is rechecked periodically during treatment. If PSA is abnormal, rises rapidly, or a prostate abnormality is detected, you will be referred urgently via local cancer pathways, as testosterone may stimulate pre-existing prostate pathology.
Optimising cardiovascular health is essential for maintaining erectile function. Testosterone replacement may improve some cardiovascular risk factors (such as body composition and insulin sensitivity) but does not eliminate underlying vascular disease. Men should be encouraged to:
-
Maintain healthy body weight through balanced nutrition and regular physical activity
-
Exercise regularly—at least 150 minutes of moderate-intensity aerobic activity weekly, as per NHS recommendations
-
Stop smoking—referral to smoking cessation services should be offered
-
Limit alcohol consumption to within recommended guidelines (14 units weekly)
-
Manage comorbidities such as hypertension, diabetes, and hyperlipidaemia through appropriate medical treatment
Reporting side effects: If you experience any side effects whilst using Testogel, talk to your doctor or pharmacist. This includes any possible side effects not listed in the patient information leaflet. You can also report side effects directly via the MHRA Yellow Card Scheme at yellowcard.mhra.gov.uk or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects, you can help provide more information on the safety of this medicine.
When to seek medical advice: Contact your GP if you experience reduced erectile function despite previously good response, as this may indicate subtherapeutic testosterone levels requiring dose adjustment or investigation for other causes. Seek urgent medical attention for symptoms suggesting serious adverse effects, including chest pain, sudden breathlessness, leg swelling, prolonged or frequent erections, signs of androgen excess (such as mood changes, aggression, or severe acne), or skin reactions at the application site. Regular engagement with healthcare services ensures that Testogel treatment remains safe, effective, and appropriately monitored throughout its duration.
Frequently Asked Questions
How long does it take for Testogel to improve erectile function?
Erectile function improvements typically become noticeable between three to six months after starting Testogel, with maximum benefits usually achieved after six to twelve months of consistent treatment at therapeutic testosterone levels.
Can Testogel be used to treat erectile dysfunction?
Testogel is not a treatment for erectile dysfunction in men with normal testosterone levels. It is licensed only for confirmed testosterone deficiency (hypogonadism) diagnosed through two early-morning blood tests showing low testosterone alongside relevant symptoms.
What monitoring is required whilst using Testogel for erectile benefits?
Regular monitoring includes serum testosterone levels at three to six months then annually, full blood count to check haematocrit (treatment stopped if above 0.54), and prostate surveillance with PSA testing and examination as appropriate, with urgent referral if abnormalities are detected.
The health-related content published on this site is based on credible scientific sources and is periodically reviewed to ensure accuracy and relevance. Although we aim to reflect the most current medical knowledge, the material is meant for general education and awareness only.
The information on this site is not a substitute for professional medical advice. For any health concerns, please speak with a qualified medical professional. By using this information, you acknowledge responsibility for any decisions made and understand we are not liable for any consequences that may result.
Heading 1
Heading 2
Heading 3
Heading 4
Heading 5
Heading 6
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur.
Block quote
Ordered list
- Item 1
- Item 2
- Item 3
Unordered list
- Item A
- Item B
- Item C
Bold text
Emphasis
Superscript
Subscript
