Here's why cardiovascular and nervous system health is the key tođ
Would you like morning wood, then understand the substrates that feed it.
I went viral on X the other day for saying something that should be obvious but apparently isnât
Androgens are not the primary driver of your erections.
Everyone and I mean everyone seems to believe the same story. Low T automatically equals bad erections go inject some TRT, problem solved lets move on.
That story is wrong
Its not not completely wrong it obviously has elements of truth
Hormones matter, but itâs wrong enough that millions of men chase a quick fix and wondering why nothing ends up changing for them.
Let me explain whatâs actually going on.
The Real Architecture
Your erection is not a hormonal event but it is primarily a neurovascular event, a coordinated event that acts like an orchestra
between your nervous system and your cardiovascular system, with hormones playing a supporting role at the end of the chain.
Testosteroneâs role is upstream and modulatory. It maintains the sensitivity of the neural pathways, supports NOS expression, maintains the structural integrity of the erectile tissue itself, and â critically â sustains libido, which is the psychogenic driver of the whole cascade. Think of testosterone as maintaining the infrastructure and the desire to initiate, but itâs not the signal that actually fires the gun.
This is why men with adequate testosterone can still have erectile dysfunction (endothelial dysfunction, autonomic neuropathy, venous leak, psychogenic inhibition via sympathetic overdrive), and why men on TRT sometimes may still need a PDE5 inhibitor â the hormonal substrate is there, but the neurovascular execution is compromised
If I had to put rough numbers on it â and I know the Pareto crowd needs numbers â it looks something like this:
Nervous system: ~45%
Cardiovascular health: ~35%
Androgens and hormones: ~15%
Everything else (psychology, pelvic floor, structural): ~5%
Now, Iâll be the first to tell you these percentages are imperfect,But thatâs the whole point. The human body doesnât operate in neat categories, The moment you try to pigeon-hole this into a single variable, youâve already missed a key point
But hereâs why I used them anyway, most of you think like me are used to thinking in binaries. Testosterone high = good. Testosterone low = bad, thatâs it
Which is your usually your entire mental model
But the same mental model kills your ability to actually solve this problem, and I want to help you the way someone else helped me before.
Let me ask you something if thatâs ok.
Do you know what happens when you overtrain? When you chronically overload your hypothalamus with stress?
Your LH gets smashed and testosterone crashes downstream.
Now, was the problem ever testosterone? the problem was your nervous system. HPA axis was overwhelmed, your hypothalamus dialed down GnRH output, and the whole hormonal cascade fell apart as a consequence of this.
Testosterone didnât cause the problem, but just a readout of the problem.
This is what I mean when I say hormones are a cog in the wheel, not the wheel itself, morning wood does correlate with LH pulses
Those gonadotropin surges first thing in the morning are contributors But that pulse is the end signal of a healthy nervous system doing the job itâs supposed to. Without the upstream machinery functioning but no amount of exogenous testosterone gives you back that functioning.
The Nervous System: Your 45%
This is where it starts, parasympathetic activation also known as your rest-and-digest state, is what initiates an erection. Nitric oxide gets released from nerve endings in the corpus cavernosum, smooth muscle relaxes, blood flows in.
If your nervous system is systematically fried for example if youâre living in a sympathetic-dominant state from tech overload, chronic stress, poor sleep, overstimulation, overtraining
How do you expect this process to initiate itself properly.
It doesnât matter what your testosterone is. how clean your diet is
If the signal isn't firing strong enough nothing WILL happen
This is why the guy whoâs anxious, overworked, under-slept, and running on caffeine can have perfect bloodwork but still canât perform
Cardiovascular Health: Your 35%
An erection is a hydraulic event
Which means your erection quality is a direct reflection of your vascular health endothelial function + your arterial compliance. Blood pressure regulation and the ability of your blood vessels to dilate on command and maintain that dilation.
This is not just abstract
If the plumbing is degraded and you have stiff arteries, poor nitric oxide production, chronic inflammation in the endothelium â (Check your HS-CRP)
Youâre trying to inflate tires with leaky pumps
In fact, erectile dysfunction is one of the earliest clinical markers of cardiovascular disease. Your penile arteries are smaller than your coronary arteries And They usually show damage first
If youâre losing erection quality fast, your body is telling you something about your vascular system years before it can shows up on a cardiac stress test.
So What Can you actually Do About It?
The fist step is to stop thinking in binaries and start thinking in layers.
Use a systematic layered approach and address each component individually first starting with the one that gives you the most diagnostic information upfront, your cardiovascular health.
Hereâs where I need you to actually engage with this. Answer these questions honestly:
Whatâs your is morning blood pressure? Are you measuring it? Most And if you are measuring it, are you sitting high first thing in the morning? Thereâs a well-documented nocturnal surge phenomenon, blood pressure naturally spikes in the early morning hours. If youâre waking up at 140/90, this is telling you something critical about your vascular state.
Are you managing your electrolytes? Sodium, potassium, magnesium â blood pressure and vascular tone
If youâre not dialing these in, youâre leaving one of your biggest levers untouched.
Are you using the sauna regularly? Heat exposure is one of the most potent tools for improving endothelial function and nitric oxide production
What does your cardio look like? Don't go with the basic âdo you do cardioâ whatâs the weekly volume, whatâs the intensity distribution, and can you sustain it without accumulating fatigue? Because if your cardio program is burying you, youâre back to the stress problem, and now youâre degrading the very system youâre trying to build.
Can you manage fatigue? This is a meta-question. Are you recovering from your training, your work, your life? Or are you running a chronic deficit? Because a chronic deficit compresses everything, nervous system function, vascular health, hormonal output,
Whatâs your calorie input?
Are you in maintenance calories? Calorie deficit? Calorie surplus?
All of this matters as you need substrates to create the hormones.
Are you using nitric oxide precursors and does your diet contain nitrates
