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  • Natasha J. Thomas, MD

Sex Therapy Topic: Men, Love and Low Testosterone

Today's post is for the fellas, and for the women who love them. I'm sure you've heard of "low T", a condition where a man's level of testosterone has begun to decline for some reason. Generally, we think of testosterone as the hormone that makes a man virile, strong and gives him sexual prowess. Knowing that testosterone levels can drop causes a general panicky sense of "Oh NO!" in many men - which sometimes leads to them ignoring the issue. Today, I want to share a few insights on how living with low testosterone can impact more than just a man's muscles or sex drive, but also his general health and his ability to relate to his partner. Let's not ignore it, let's be informed and do something!


So, What Does Testosterone Really Do?

Testosterone is the "male hormone" most important in male health and functioning. It is a major contributor to the following aspects of a man's life:

  • Libido

  • Muscle mass

  • Bone strength

  • Feelings of vitality

  • Ability to complete tasks

When levels of available testosterone are low in a man's body, it can result in him experiencing a host of issues like irritability, loss of bone density and muscle mass, anemia, & insulin resistance (as seen in diabetes).

What Causes Testosterone Levels to Decline?

Low levels of testosterone can be associated with various medical conditions, such as:

  • HIV

  • Long-term use of certain steroids, antifungals, pain medications, or chemotherapy

  • Excessive alcohol use

  • Kidney disease

  • Brain tumors

Low T should also be suspected in young men who easily break bones or are found to have osteoporosis.

For the purposes of today's blogpost, we'll focus only on low testosterone that is the result of normal aging. Believe it or not, studies show testosterone levels start to decline by a small percentage every year after the age of 35 as part of the normal aging process! I make this point not to alarm you, but to help you realize that it is typical, common and nothing to be ashamed of.

Do I Need to See My Doctor?

If you believe that low levels of testosterone are starting to cause problems in your health, I'm encouraging you to talk with your doctor. Mention if you're beginning to develop:

  • Sadness or irritability (with no cause)

  • Low interest in sex (that is not related to stress or relationship problems)

  • Low energy

  • Declining muscular power

  • Loss of body hair

  • Growth of breast tissue

  • Hot Flashes

Adult men that have low levels of testosterone with no medical cause may be treated with testosterone. It's thought to be safest only to increase testosterone to the low range of normal for young men, to avoid causing problems with the prostate and other organs. It is important to note, though, that when testosterone levels slowly decline over time, they may not cause symptoms. In that case, treatment usually is not indicated. See if your doctor would recommend hormone testing and possibly treatment.

And Why Is a Psychiatrist Writing About This?

As you know, I'm a psychiatrist and sex therapist. However, you may be surprised to find that I see low testosterone interrupt communication with spouses much more than I hear of it ruining sex lives. Why? Because some men with low testosterone become very depressed. Others who are already prone to mood problems and sadness may feel even worse once their level of testosterone begins to decline.

I literally cannot count how many partners and wives of men with declining testosterone reach out to me for help. Generally, they are frustrated - because their loved one is clearly beginning to feel and act differently, and won't seek help. Women tell me their husbands are withdrawn, angry, isolated, & have no desire in sex (and seem unmotivated in general). Not surprisingly, the couple begin to become distant, and even resentful, of one another. Most commonly, the women making these complaints are married to guys between the ages of 45 and 75.

Some other symptoms of depression are:

  • Low mood

  • Loss of interest or joy

  • Feelings of guilt, hopelessness, and/or helplessness

  • Fatigue

  • Physical pain or slowness

  • Poor concentration

  • Changes in appetite

  • Thoughts of death or suicide

Even though not every man with this type of presentation will have low testosterone, many will. Of the guys that I do get to talk to about this issue, they will eventually admit they feel lousy. Why not do something about it? Psychiatrists can help with medications and therapy, but studies on the efficacy of low testosterone show modest improvements in mood, bone density and sexual functioning, among other improvements. It's a health problem that should be addressed.

Start here with this basic information on "Low T". Schedule an appointment with your doctor for a physical exam, and a conversation! Even if they don't recommend testosterone therapy for you, they can work with you to find other solutions. Have the talk, you'll be glad you did!


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*This article is not intended to diagnose or treat any condition and does not take the place of an evaluation by a medical professional.

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