Functional Medicine
ED Treatment
ED isn't just about blood flow. It's often the first sign that something deeper is off. Low testosterone, high estrogen, insulin resistance, cardiovascular dysfunction, or stress hormones. We test for all of it and treat the root cause, not just the symptom.
ED Is a Warning Sign, Not Just a Bedroom Problem
Most men think of erectile dysfunction as a sexual issue. It's not. It's one of the earliest warning signs that something is going wrong in your body. ED can show up years before a heart attack, a diabetes diagnosis, or a serious hormone deficiency. Your body is telling you something. The question is whether anyone is listening.
Here's what's usually happening under the surface. Testosterone has been dropping 1 to 2 percent per year since your early 30s. By the time you're 45 or 50, you could be operating at half your baseline. That affects everything: mood, energy, motivation, body composition, sleep, and yes, erections. But testosterone is only one piece.
Estrogen plays a bigger role than most men realize. Colin Renaud (DC, PA-C), one of our providers, is direct about this: "Believe it or not, men need estrogen to maintain and get an erection." When testosterone is low and estrogen is out of balance (either too high or too low), erectile function suffers. Most men don't know this. Neither do most of their doctors.
Then there's insulin resistance. When blood sugar regulation breaks down, it damages the lining of your blood vessels. This reduces nitric oxide production, the molecule that dilates blood vessels and delivers blood to tissue. Including the tissue that matters for erections. So a man with pre-diabetes or metabolic syndrome has a vascular problem that a pill can't fix.
Stress is another major factor. Chronic stress drives cortisol up and testosterone down. Colin Renaud (DC, PA-C) puts it simply: "Stress is one of the most toxic things on the body, physically, mentally, spiritually, physiologically." If your cortisol is running high for months or years, your body is prioritizing survival, not reproduction. Erectile function gets deprioritized at the cellular level.
Inflammation ties it all together. Damaged blood vessels, poor metabolic health, hormonal imbalance, and chronic stress all produce inflammation. And inflammation makes every one of those problems worse. It's a cycle, and a prescription for Viagra doesn't break it.
“We do NOT want to lower estrogen too much. Most men do not need estrogen blockers. Estrogen is really, really important to maintain a man's mood. And believe it or not, men need estrogen to maintain and get an erection.”
Colin Renaud, PA-C: Men Need Estrogen for Erections
Watch at 34:00→“We do NOT want to lower estrogen too much. Most men do not need estrogen blockers. Estrogen is really, really important to maintain a man's mood. And believe it or not, men need estrogen to maintain and get an erection.”
Colin Renaud, PA-C: Men Need Estrogen for Erections
Provider Insight
“If we are catching hormone decline early, 100% it should be caught early and dealt with early. We see decline in hormones in men in their 30s.”
Colin Renaud, DC, PA-C: Catching Hormone Decline Early
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What We Actually Test (And Why Your Doctor Didn't)
Walk into a conventional doctor's office with ED and you'll get one of two responses. Either they write a prescription for a PDE5 inhibitor (Viagra, Cialis) without running any labs, or they check total testosterone once, see that it falls within the reference range of 300 to 1,000, and tell you you're fine.
Neither approach answers the real question: why is this happening?
We run a full workup. Not because we like running tests. Because ED is almost never caused by one thing, and you can't fix what you don't measure.
What we test:
- Total and free testosterone (not just total, which can be misleading)
- Estradiol (estrogen levels in men, critical for erectile function and mood)
- Prolactin (elevated levels can suppress sexual function)
- Fasting insulin and HbA1c (insulin resistance damages blood vessels)
- Thyroid panel (TSH, free T3, free T4, thyroid antibodies)
- Inflammatory markers (CRP, ESR)
- Cortisol (stress hormone, depletes testosterone over time)
- Vitamin D, B12, ferritin, magnesium, zinc (building blocks for hormone production)
- Full lipid panel including particle size (cardiovascular risk assessment)
- InBody 770 body composition scan (visceral fat, lean muscle mass, metabolic rate)
This gives us a full picture. Not just "is testosterone low?" but "what's driving the dysfunction, and where do we intervene first?"
Colin Renaud (DC, PA-C) explains the gap in conventional care: "A man in his early 40s comes in with a testosterone of 320. His conventional doctor says, 'You're totally fine.' But he's not, though. That's the thing." The reference range starts at 300. Functional medicine targets 700 to 1,000. That gap between "normal" and "optimal" is where most men with ED are stuck.
Treatment That Goes Beyond a Pill
PDE5 inhibitors (Viagra, Cialis) have their place. They can help with blood flow in the short term. But they don't fix the reason blood flow was impaired. They don't restore hormone balance. They don't reverse insulin resistance. They don't reduce inflammation or lower cortisol. They manage a symptom while the root causes get worse.
We build a protocol around what your labs actually show.
Hormone optimization. If testosterone is low, we bring it up. For some men, that means testosterone replacement therapy (TRT). For younger men or those planning to have children, we use alternatives like enclomiphene, an oral medication that raises testosterone without suppressing fertility. We also monitor and optimize estrogen levels. Most men do not need estrogen blockers. Reflexively blocking estrogen (which many testosterone-only clinics do) can actually make erectile function worse.
Metabolic repair. If insulin resistance is present, we address it through dietary changes, body composition improvement, and sometimes GLP-1 medications. Fixing metabolic health improves blood vessel function, which directly improves erectile function. This takes time, but the changes stick.
Stress and cortisol management. Sleep optimization, stress reduction strategies, and targeted supplements like ashwagandha (which has evidence for supporting testosterone levels and managing stress). We work with what your life actually looks like. Nobody can quit their stressful job overnight. But small, consistent changes in sleep, recovery, and daily habits compound over time.
Nutritional support. Vitamin D deficiency is common in New England, especially in winter months, and it significantly impacts testosterone optimization. We also assess and correct deficiencies in magnesium, zinc, B12, and ferritin, all of which play a role in hormone production and energy.
PDE5 inhibitors when appropriate. Yes, we prescribe them when they're needed. But they're part of a plan, not the plan. A man who needs Viagra at 45 because his testosterone is 320, his insulin is elevated, and his vitamin D is tanked deserves more than a pill. He deserves to know why it's happening and what he can do about it.
“If we are catching hormone decline early, 100% it should be caught early and dealt with early. We see decline in hormones in men in their 30s.”
Colin Renaud, DC, PA-C: Catching Hormone Decline Early
Watch at 55:00→The Med Matrix Process
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Result: You leave with a clear understanding of what is happening and exactly what to do about it.
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- Continued monitoring of your labs and markers
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Result: Real, measurable progress you can feel and see in your numbers.
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FAQ
ED Treatment FAQ
No. Low testosterone is one common cause, but ED can also be driven by insulin resistance, high estrogen, elevated prolactin, thyroid dysfunction, chronic stress and high cortisol, inflammation, cardiovascular dysfunction, vitamin deficiencies, or a combination of these. That's why we run a full workup instead of just checking one number. Treating the wrong cause doesn't work. You need to know what's actually happening first.
Maybe in the short term, while we address the root causes. Many men reduce or stop PDE5 inhibitors entirely once their hormone levels, metabolic health, and vascular function are optimized. The goal is to restore your body's own ability to function, not to keep you on medication indefinitely. Your provider will give you an honest timeline based on your labs and health history.
It's more common than you think, and it's a sign that something needs investigation. Younger men with ED often have hormonal imbalances, insulin resistance, high stress, sleep problems, or nutrient deficiencies. In some cases, environmental exposures (chemicals, mold, toxins) can drive testosterone dangerously low. A 32-year-old man should not have a testosterone level of 88, but our providers have seen exactly that. If you're dealing with ED in your 20s or 30s, get tested. Don't wait.
Direct testosterone replacement can reduce sperm production in some men. This effect is generally reversible, but it needs to be managed carefully. For men who are trying to conceive or want to preserve fertility, we use alternatives like enclomiphene. It's an oral medication that stimulates sperm production, which indirectly raises testosterone without suppressing natural production. You get the benefit of higher testosterone without the fertility risk.
Initial onboarding runs about $1,200 to $1,500 all-in. That covers your blood panel, body composition scan, provider prep, and your full one-hour provider visit. Follow-up visits are $275. Hormone therapy typically costs $70 to $200 per month depending on your protocol. Supplements are $20 to $100 per month. We accept HSA, FSA, CareCredit, and all major cards. New patients get a $100 voucher toward their first visit.
Completely. We treat ED patients regularly. Your health information is protected under HIPAA, and our team is professional and discreet. There's no judgment here. Most men who come in for ED find that the underlying issues are affecting other areas of their health too (energy, weight, mood, sleep). Treating the root cause improves everything, not just sexual function.
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