So how can testosterone therapy help doctor or would this be considered what is known as ED erectile dysfunction so-called impotence? So those are two separate issues which commonly get grouped into the same complaint if you will and patients come in saying hey I have challenges with erectile function but don’t really have challenges with libido and libido is one thing erectile dysfunction is the other what I tell patients is look ED has to do with plumbing ED has to do with to do with can the circulation be proper so that your situation can be improved There is a difference between someone’s desire to perform and then there’s a difference between someone’s low performance sure those are two different things that are treated differently I’m heraring. It’s the difference between I can and I want to. So I want you to walk over if you don’t mind now to the bio digital human because obviously we’re talking about circulation here doctor exactly and that circulation happens inside vessels so let’s pretend just for the magic of pretending this is a vessel inside the male body part So this is a blood vessel in anybody to be quite honest so but this is just an animation that can simply explain what can happen to an artery so arteries you know a structural this is like for example a hose where it’s been cut open for the animation purposes and you can see here how the yellow part is plaque and plaque buildup so of course we have micro vascular small blood vessel circulation and we have macro vascular circulation so macro vascular circulation are the big arteries in your heart and your neck and your brain whatever but micro vascular circulation like commonly referred to in diabetes is in the kidney in the retina and of course in the penile circulation as well so imagine if the arteries are really really really thin now we have issues with circulation in really really thin arteries and as they start to get occluded then we have a circulation issues so popular medications like the little blue pill and etc attack these blood vessels not to get rid of the plaque by the way but to improve the Vasil dilatation and open these arteries up so therefore circulate you can solve the erectile dysfunction but again that’s a different from having the desire desire may still be there the circulation may be occluded.