A study of more than 3,400 former National Football League players, average age 52, found that those who had had a concussion were at increased risk for low testosterone and erectile dysfunction, regardless how young or old they were (JAMA Neurology, Aug 26, 2019). Previous studies have found the same results in boxers and soldiers (J Clin Med, 2015;4(7):1463-1479), but this is the largest study on football players. Eighteen percent said that they had low testosterone and 23 percent reported erectile dysfunction. The probable cause is head trauma damage to the pituitary gland that can reduce blood testosterone levels.

The football players reported how often head trauma caused them to feel dizzy, nauseated, or disoriented; to have headaches, loss of consciousness, or visual disturbances; and whether they were taking medication for low testosterone or erectile dysfunction. Those who suffered the most concussions were more than twice as likely to report taking medication for low testosterone or erectile dysfunction, compared to those who reported the fewest concussion symptoms. The authors corrected their data for other causes of low testosterone, such as heart disease, diabetes, sleep apnea, depression, taking prescription pain medication, taking performance enhancing drugs, high blood pressure, obesity, high cholesterol, or a history of prostate or testicular cancer.

My Recommendations
• Try to avoid head injuries.
• If you are a man who has low sexual desire or inability to achieve or maintain an erection, consult a doctor as soon as possible. These can be signs of impending heart attacks, diabetes and other serious conditions.
• If you have had a history of head trauma, your doctor will probably recommend getting an MRI of your brain.
• If you have low testosterone, you can replace testosterone with gels or injections. Never use testosterone pills because they can cause severe liver damage.
• Inability to achieve or maintain an erection can be treated with several drugs on the market today.
• Many lifestyle changes can help to treat erectile dysfunction.