Testosterone influences much more than just a man’s sex drive.
Additionally, testosterone helps men maintain healthy bone density, influences how body fat is distributed, affects muscle mass and strength, and directs configuration of facial and body hair. It also affects production of red blood cells and sperm.
Peak testosterone usually happens in late adolescence and young adulthood. After that, testosterone levels gradually decline with age. After age 30 to 40, testosterone levels drop by about 1% per year. When a man has measurably low testosterone levels, it’s important for doctors to determine whether they’re caused by the natural aging process, or by disease or abnormality. This is complicated by the fact that the symptoms of low testosterone can mimic the symptoms of many other disorders, such as depression.
Symptoms of Low Testosterone: Not Always What You Expect
While you might expect low testosterone levels to make a man’s sex drive disappear, that’s not always the case. Some men with low testosterone have normal sex drives, while some men with normal testosterone may have low sex drive. But it’s generally true that if testosterone levels are low enough, sex drive will decline to some extent. Other symptoms of low testosterone levels may have little to do with sex drive.
Sleep disturbances, altered sleep patterns, and insomnia may be caused by low testosterone. Physical changes caused by low testosterone include an increase in body fat and decrease in muscle mass and strength. Bone density may drop as well. Loss of body hair and lack of energy may accompany low testosterone levels, as can decreased motivation and confidence. Depression and difficulty concentrating can also be symptoms of low testosterone.
A study of American men found that around 11% reported lack of sex drives. When men’s testosterone levels were measured, around 28% of the men with low testosterone had low sex drive, and the average age of these men was only 47. But, perhaps surprisingly, low testosterone by itself is rarely the cause of erectile dysfunction (ED).
Low Testosterone and Erectile Dysfunction: A Complicated Relationship
While low testosterone is rarely singled out as the cause of ED, it often accompanies atherosclerosis (coronary disease), which quite often is a major cause of ED. Around one-third of men who discuss ED with their doctors have low testosterone, but doctors believe that this is because in men predisposed to ED, low testosterone can make it worse.
Low testosterone levels are also linked with other factors that lead to erectile dysfunction, including:
- Endothelial dysfunction (disorders of the lining of blood vessels)
- Metabolic syndrome
Sometimes low testosterone causes other problems, and sometimes other problems cause low testosterone. In some cases it’s not clear which came first. The important thing is that low testosterone and ED may be related, but it’s not a straightforward cause-effect relationship.
Should Men With ED or Low Sex Drive Take Supplemental Testosterone?
Should men with low sex drive or ED take supplemental testosterone? If they have testosterone levels that fall within the normal range, probably not, because long term benefits and risks aren’t known yet. But in men who have clinically low levels of testosterone, supplemental testosterone, prescribed in the form of patches, gels, pellets, or injections can bring testosterone and sex drive back up. Though studies are ongoing, it’s unclear whether supplemental testosterone benefits older men who are healthy otherwise.
Anecdotal evidence suggests that some men feel younger and more vital when they take testosterone, but few scientifically rigorous studies have been conducted. The few small studies that have taken place have yielded mixed results.
Risks of Testosterone Therapy
Like most types of hormonal therapy, testosterone therapy has its risks. Some of the risks of testosterone therapy include:
- Potential for sleep apnea, which causes breathing to stop and start during sleep and can be dangerous
- Development or worsening of acne
- Benign enlargement of the prostate gland and growth of existing prostate cancer
- Development of breast tissue
- Low sperm counts
- Shrinkage of testicles
- Increased risk of deep vein thrombosis (blood clots)
The exact relationship between testosterone therapy and risk for heart disease has not been studied enough for the risks to be clearly definable yet. Any man considering testosterone therapy should talk to a doctor and have testosterone levels measured. Doctors typically measure hormone levels more than once before making a determination whether levels are too low.
If measuring of testosterone reveals a medical condition that is responsible for the lower testosterone levels, doctors may prescribe testosterone therapy to bring levels back to within the normal range. But most doctors don’t prescribe testosterone therapy for men whose levels are falling due to age but remain within the bounds of what’s normal.
Natural Ways to Improve Hormone Balance and Sex Drive
Men whose testosterone levels are within the normal range, but who have low sex drive and / or ED, are often advised by doctors to adopt lifestyle changes to naturally boost testosterone and improve arterial health – both of which can help with low sex drive and ED. Common advice on maintaining healthy testosterone levels and improving ED includes:
- Cutting out processed, sugary foods and replacing them with whole, unprocessed foods wherever possible
- Regular exercise, to improve circulation and arterial health, both of which can affect erection quality
- Taking a multivitamin / mineral supplement as well as fish oil supplements for omega 3 fatty acids
- Reducing alcohol consumption – too much of which affects both sex drive and erectile function
- Quitting smoking, because of smoking’s effect of narrowing blood vessels and compromising cardiac health
Testosterone Affects Sex Drive in Women Too
Women are affected by testosterone too, though the hormone is present in much smaller amounts in women. The effect of testosterone on sex drive in women tends to play a larger role after menopause. While women’s sex drive is strongly influenced by emotional well-being, relationship quality, and even psychosocial factors, testosterone is also linked to feelings of desire in women. But the effects of testosterone levels on women’s libido are far more subtle than they are for men. Plus, long term effects of testosterone supplementation in women aren’t well known, so testosterone is not often prescribed to women with low sex drive.
Testosterone and sex drive may seem to have a strong and straightforward connection, but it’s actually quite complex. “Normal” testosterone levels include a wide range, and a man’s sex drive isn’t necessarily correlated with his testosterone levels as long as they’re within the normal range. Testosterone production drops with age, but the risks of testosterone supplementation in men who have levels within the bounds of normal are simply not known yet.
A healthy lifestyle that includes a balanced diet, exercise, moderation of alcohol consumption and kicking habits like smoking have been shown to help men with sex drive and erectile function, and in men who take medications for ED, a healthy lifestyle can help the medications work better.
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