Hormonal causes of erectile dysfunction (ED) in Riyadh are an important but often overlooked factor in male sexual health. Hormones play a critical role in regulating sexual desire, arousal, and erectile function. Among these, testosterone is the primary hormone influencing libido and erectile strength. A decline in testosterone levels, which naturally occurs with age, can lead to reduced sexual desire, difficulty achieving or maintaining an erection, and overall decreased sexual performance. In Riyadh, men may experience hormonal imbalances due to lifestyle factors, chronic illnesses, or age-related changes, making awareness of these causes essential. Besides testosterone, other hormones can impact erectile function. Thyroid hormones, for instance, regulate metabolism and energy levels, and imbalances—whether hypothyroidism or hyperthyroidism—can interfere with sexual performance. High levels of prolactin, often due to pituitary gland issues, can suppress testosterone production and reduce libido. Similarly, adrenal gland disorders that affect cortisol or other hormone levels can disrupt the hormonal balance necessary for healthy erectile function.