There are not many things that can prevent a man from feeling manly like poor sexual performance. Whether the relationship is in the "honeymoon phase" or "empty nesters" that now have the quality time that has been 20 years in the making, do not allow the lack of being able to perform in the bedroom restrain the man that the relationship needs.
Not being able to perform sexually or not being able to maintain an erection is a symptom of low testosterone. Erectile Dysfunction is almost always caused by low blood flow to the penis. This is a result of other conditions such as hardening of the arteries, high blood pressure, and high cholesterol. These conditions narrow the blood vessels and reduce blood flow to the penis. Low testosterone may affect the desire for sex but it rarely causes Erectile Dysfunction. If suffering from ED but still have a desire for sex, hormone replacement therapy may not be the solution needed.
Testosterone does improve sexual performance because it is a sex hormone. Testosterone levels naturally rise in response to sexual arousal and activity. Men with higher levels of testosterone usually have greater sexual activity. Older men need more testosterone for libido and erectile function. It is important to note that erectile dysfunction is often due to other conditions or medications rather than low testosterone levels.
Studies show that testosterone therapy can benefit sexual health and performance. It also shows that there is a maximum level of testosterone before there is no increased response.