Testosterone, one of the sex hormones, is strongly linked in people’s minds with masculinity. When production of this hormone starts to fall
(usually in men in their late 20s or early 30s), one side effect is lost libido or low sexual desire. While the symptoms of low-testosterone
(also called low-T or hypogonadism) are varied, a flagging libido is a classic sign. This can affect women as well as men, although it’s not
usually as dramatic for females because sexual desire in women plays out differently than it does in men.
We can measure circulating testosterone with a simple blood test. A level below 400 ng/dL (nanograms per deciliter) is considered sub-par. But even before a blood test confirms the diagnosis, many males suspect that there is something wrong.
Testosterone not only makes a man more receptive sex, it enables him to have and keep an erection. Ironically, low testosterone can cause spontaneous erections (during sleep, for instance) as well as contribute to erectile dysfunction (ED).
Where once low-T was seen as an inevitable aspect of growing old, it’s now among the many age-related problems that lend themselves tohormone replacement therapy.
Hypogonadism is experienced by all men at some point, as testosterone production levels off when males are in their teens and then begins to drop with each decade of age. About 30 million men report having some problem with erectile dysfunction.
The number of complaints about weak libido is unknown because many men see their lack of sexual desire as shameful— or they believe that it’s a natural consequence of aging (or stress, or illness) and that nothing can be done to address the problem. The widespread allusion to sexual desire in the media, in comedy and in everyday discourse— and its association with male virility— gives us reason to believe that low libido may be underreported by a wide margin.
By the way, low testosterone makes itself known in other ways: Hair loss, fatigue, increased body fat, loss of muscle tone, low quantity of semen (and infertility), moodiness, anxiety and depression are just a few of the other signs of hypogonadism.
Testosterone replacement therapy (TRT) is widely prescribed to counter loss of desire in men. The hormone may be administered through injection,
patch, gel or lozenge.
A skin patch containing androgens (the family of male hormones that includes testosterone) may be applied daily to the arm or upper body. This is called transdermal TRT. Testosterone supplementation is also available as a gel. Another patch is designed to be inserted into the mouth twice a day.
Injections or pellets that are implanted under the skin is a longer-term method of administering testosterone. Your doctor can explain the pros and cons of the various methods of treatment, and which one would be right for you.
While loss of interest in sex is often the red flag that prompts a man to visit his doctor, it is not the only sign of low-T. Other symptoms such
as loss of bone density and moodiness, among others, may also be alleviated with testosterone replacement therapy. The response to therapy varies
greatly from one individual to another.
For one man, it may be enough to treat ED. Another could be pleasantly surprised to find that he has more energy, finds it easier to concentrate on difficult tasks, and is less irritable with colleagues, friends and family.
Still others may notice a slowing of hair loss, or better results from his workout at the gym.
Because testosterone affects so many bodily functions that correspond with masculinity, its effects are broad and varied. Whether it’s low libido or a general feeling of poor health, it’s possible that TRT is all you need.
Males who have low levels of circulating testosterone may show any of the following signs and symptoms:
When a patient makes an appointment to see the doctor, our diagnosis starts with eliciting information about his health and lifestyle. Some of the questions we may ask include the following:
Most of the answers to these questions are a function of low-T. From here, we may go on to confirm the diagnosis.
At this point, the doctor may order lab work to analyze testosterone production. Men over 40 or those with a family history of prostate cancer would have a rectal exam to screen for prostate problems. After a man is prescribed TRT, he is scheduled for a check-up every three to six months, after which yearly check-ups will suffice.
Testosterone replacement therapy is now used by an estimated 400,000 American men. This is a fraction of the men who report some
experience with ED, and probably an even smaller fraction of the men who wonder where their sexual appetite has gone. Some public health
officials have speculated whether the population, living eight decades or more, is being underserved by labeling men in their 50s and 60s
Doctors definitely are more sensitive these days to how flagging sexual desire may be an indicator of overall health and well-being. Sexual desire reflects a man’s desire for the good things in life. It affects his quality of life, his feelings of self-worth, enjoyment of everyday activities, responsibilities and relationships. Many males feel that lack of sexual desire is the beginning of a long decline that can only end in illness and death. It’s no wonder it is a much-dreaded syndrome.
Hormones start to decline when a man is barely out of his teenage years, which hardly seems like the beginning of old age. Moreover, medical science has identified the source of the problem, and we can now measure how much hormone production may have fallen to produce this sense of ineptitude and lethargy. It’s no longer necessary to feel like a bystander for decades of one’s life. Call today to learn more about loss of libido and how it can be reversed with testosterone replacement therapy.