September 28, 2026
This article is sponsored by Yes Clinic.
Erections taking more work than they used to? Sex drive gone quiet and staying that way? If it started during or after SARMs, the timing isn’t something to brush off, and you deserve a straight answer about it.
Here’s the short version. Can SARMs cause erectile dysfunction? The FDA lists sexual dysfunction, infertility and testicular shrinkage among the problems SARMs can cause, and it calls them unapproved drugs that mimic testosterone. So the first move isn’t an ED medicine. It’s a licensed clinician, some blood work, and an honest list of exactly what you took.
Let’s break down what the FDA actually says, how SARMs can drag your own testosterone down, why low libido is a different problem from weak erections, and which tests make sense before anyone writes a prescription.
SARMs (selective androgen receptor modulators) are, in the FDA’s words, “chemical substances that mimic the effects of testosterone and anabolic steroids.” No SARM is FDA-approved. The FDA treats products sold as SARMs as unapproved drugs, not dietary supplements, and says it hasn’t reviewed them for safety or effectiveness. For where they stand legally, see our guide on whether SARMs are legal.
The FDA’s page on risky bodybuilding products, current as of 2 December 2025, says SARMs have the potential to cause:
The FDA adds that life-threatening reactions, including liver injuries that needed hospital care, have already happened. The same page describes a product sold as YK-11: after a user had a stroke, the FDA tested it and found an anabolic steroid the label never listed.
Some products also say “not for human consumption” and then ship with dosing instructions anyway. Our piece on research vials versus a prescription explains what that label really means.
In a 2017 JAMA study, researchers bought 44 products sold online as SARMs. Only 23 contained a SARM at all, 11 held substances that weren’t on the label, and just 18 matched the amount printed on the bottle. That snapshot dates from 2016, but it’s exactly why your clinician needs the product names, not just “I ran some SARMs.”
Most users never ask a doctor, either. In a 2022 survey of 343 SARM users, more than 90% bought online and didn’t consult a physician.
One documented route runs straight through your own testosterone.
Prescription testosterone’s label explains the mechanism. When androgens come from outside the body, your own testosterone release is shut down through feedback on luteinizing hormone (LH), and at large doses sperm production can drop too. The FDA says SARMs mimic testosterone, and a 2013 placebo-controlled trial measured that suppression directly.
That trial, published in the Journals of Gerontology, gave 76 healthy men aged 21 to 50 either the SARM LGD-4033 or a placebo for 21 days. Total testosterone fell, and so did HDL (“good”) cholesterol, more so at larger amounts. Levels came back after the men stopped.
Keep that in perspective, though. Three weeks of a known compound, with researchers drawing blood, tells you very little about months of a product whose label may be wrong.
The testosterone label says people who take more than prescribed amounts may get withdrawal symptoms for weeks or months, including decreased libido, depressed mood and hypogonadotropic hypogonadism (when the brain stops signaling the testes). In a 2023 survey of 470 steroid users, 57% of those who stopped reported reduced libido and 72.9% reported low mood.
None of this tells you what caused yours. The American Urological Association’s guideline on erectile dysfunction says ED often has more than one cause, and lists vascular disease, tobacco, hormone disorders, medication side effects and psychological issues among the common risk factors.
Get checked soon if you notice these. The FDA says to see a health care professional for nausea, weakness or fatigue, fever, belly pain, chest pain, shortness of breath, yellow skin or eyes, or brown urine after using these products. Chest pain or trouble breathing? Call 911.
Here’s something a lot of guys miss: an ED medicine works on blood flow. It can’t touch desire, and its own label says so.
Sildenafil and tadalafil are PDE5 inhibitors. They help blood flow into the penis during arousal. The tadalafil label says the drug has no effect without sexual stimulation, and its patient leaflet says it does not “increase a man’s sexual desire.”
The urology guideline tells clinicians to ask about low libido separately, because successfully treating ED won’t fix it. In the European Male Aging Study it cites, low desire, weak morning erections and ED all tracked with testosterone levels.
So before anyone picks a treatment, split your symptoms:
| What you notice | What the sources say | What to bring up |
|---|---|---|
| Weaker erections, normal desire | PDE5 medicines act on blood flow during arousal (labels) | Heart health, blood pressure, nitrates, poppers |
| Low or absent desire | ED medicines don’t raise desire (tadalafil label) | Morning testosterone and a hormone work-up |
| Both, plus smaller testicles | FDA lists sexual dysfunction and testicular shrinkage | Hormones, and fertility if you want kids |
| Yellow eyes, dark urine, belly pain | FDA lists these as symptoms to get checked | Liver tests, soon |
The urology guideline says men with erectile dysfunction should get a full medical, sexual and psychosocial history, a physical exam and selected lab tests, including a morning total testosterone. It also calls ED a risk marker for heart disease, which is one more reason not to skip the checkup.
After SARMs, that blood work has an extra job. The FDA lists liver injury among SARM harms, and both PDE5 labels change how the drugs are used in men with liver impairment (tadalafil isn’t recommended when it’s severe).
| Test | Why a clinician may order it |
|---|---|
| Morning total testosterone | The guideline recommends it for men with ED |
| Fasting glucose or HbA1c | One of the guideline’s basic tests for some men |
| Fasting lipids | A basic guideline test; LGD-4033 lowered HDL |
| Kidney function (BUN, creatinine) | A basic guideline test |
| Liver tests | FDA lists liver injury; liver impairment changes PDE5 use |
| Thyroid tests, PSA | May suit some men, per the guideline |
The guideline wants at least two morning readings before anyone calls testosterone low. Our guide to low testosterone numbers picks up from there. Labs are priced separately; Yes Clinic lists panels on its diagnostics page.
We get it. Telling a clinician you used SARMs can feel like a confession. Their own guideline treats it as routine: the history it describes covers medications and substance use. If you kept records, bring them:
Your history may change what a clinician prescribes, or whether they prescribe at all. That’s exactly why it matters. The FDA’s consumer update notes that people may not realize a product is behind their symptoms.
One more thing: a prescription doesn’t cancel any risk the FDA lists for SARMs. The FDA’s advice is not to buy them, and to talk to a health care professional about anything you use to build muscle. You won’t find a PCT protocol or a recovery timeline here, because nobody can honestly promise when, or whether, things come back.
Depending on what your labs show, expect some mix of:
Sildenafil and tadalafil are the active ingredients in FDA-approved ED medicines. Duo combines sildenafil 20 mg and tadalafil 7 mg in one dissolving tablet; it is compounded, so it is not FDA-approved, and FDA does not review compounded drugs for safety, effectiveness or quality.
| Plan | Sizes | Price | Works out to |
|---|---|---|---|
| Sildenafil 50 mg, as needed | 30 / 60 / 90 tablets | $89 / $129 / $159 | about $2.97 down to $1.77 a tablet |
| Tadalafil 20 mg, as needed | 30 / 60 / 90 tablets | $99 / $149 / $189 | about $3.30 down to $2.10 a tablet |
| Tadalafil 5 mg, daily | 1 / 3 months | $109 / $229 | about $76 a month on 3 months |
| Duo, dissolving tablet | 10 / 30 tablets | $89 / $199 | $8.90, about $6.63 a tablet |
Duo’s 10 tablets (which come to $99), the 30- and 60-tablet sildenafil and tadalafil plans and the 1-month daily plan add $10 shipping; larger plans ship free. You see the full total before you pay. Every plan needs a prescription, and a licensed clinician decides whether treatment is appropriate. The consultation is included with no membership fee. You aren’t charged for medication if a clinician doesn’t prescribe.
Dispensed medication can’t be returned or refunded. Labs are priced separately, and availability varies by state.
Plans: sildenafil 50 mg and tadalafil.
Yes Clinic is a LegitScript certified telehealth company, not a pharmacy. LegitScript is a private company, not a government agency, and Yes Clinic pays it for the review. You can look up the certification yourself, then run these seven checks on Yes Clinic or any other online clinic.
The gaps: there’s no phone line. The care team answers through the portal, support@yesclinic.com isn’t watched around the clock, and health information shouldn’t go by email. In an emergency, call 911.
Good fit if you:
Skip it if you:
ED or low libido after SARMs is common enough that you shouldn’t feel weird about it, and serious enough that you shouldn’t guess at the fix. The FDA lists sexual dysfunction among SARM harms, a controlled trial showed a SARM can push testosterone down, and an ED medicine only covers part of the picture.
Start with a licensed clinician, morning blood work and a complete, honest list of what you took. If a prescription makes sense after that, Yes Clinic’s ED plans start at $89 plus shipping, with the consultation included.
Frequently Asked Questions
FDA lists sexual dysfunction, infertility and testicular shrinkage among SARMs side effects, and calls SARMs unapproved drugs that mimic testosterone. In a 2013 controlled trial, the SARM LGD-4033 lowered men’s total testosterone. Anyone with ED after SARMs should see a licensed clinician and say exactly what they took.
Nobody can promise that it will, or when. A short controlled study says little about longer use of mislabelled products, and the same uncertainty applies to ED after steroids. A clinician with your blood work should track it.
They aren’t designed to. The FDA-approved tadalafil label says it doesn’t increase a man’s sexual desire and has no effect without sexual stimulation. Low libido needs its own work-up with a clinician, often starting with blood work.
Only if a licensed clinician decides it’s appropriate after reviewing your full history, and never with nitrates or poppers. Both labels change use in men with liver impairment, and FDA lists liver injury among SARM harms, so the clinician needs to know what you took.
Important safety information. Neither sildenafil nor tadalafil carries a boxed warning. Never take them, or Duo, with nitrates (such as nitroglycerin or isosorbide) or with recreational “poppers” (amyl or butyl nitrite): the combination can cause a sudden, dangerous drop in blood pressure that may be fatal. Do not take with riociguat, or if sexual activity is inadvisable for your heart. Tell your provider about alpha-blockers, blood pressure medicines, ritonavir or ketoconazole, heavy drinking, heart disease, a recent heart attack or stroke, liver or kidney problems, and any non-prescribed product you’ve used, SARMs and steroids included. An erection lasting more than four hours is a medical emergency. Stop and seek care for sudden vision loss or a sudden decrease or loss of hearing. Common side effects include headache, flushing, indigestion, nasal congestion, back pain and muscle aches. Full information at yesclinic.com/important-safety-information.
Yes Clinic is a LegitScript certified telehealth company. It is not a pharmacy and does not make or compound medication; a licensed US pharmacy prepares and labels your prescription. Duo is a compounded medication and is not FDA-approved; FDA does not review compounded drugs for safety, effectiveness or quality. A prescription is required and is issued only if a licensed clinician decides it is appropriate; availability varies by state. Yes Clinic does not sell or supply SARMs, and nothing here endorses their use.
DISCLAIMER: The information provided above is not intended to substitute professional medical advice, diagnosis, or treatment. Always seek your physician’s advice or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have seen or read.We bear no responsibility or liability for your use of any compound.Â
