As men age, the testosterone, the male hormone produced in the testicles, decreases just as a woman’s estrogen levels decrease at the time of menopause. Low testosterone can dramatically affect a man’s sex drive and sexual performance. Also low testosterone can reduce your ability to have satisfying sex. Lack of sex drive and erectile dysfunction are sexual problems that can result from low testosterone. If low testosterone is the cause, effective treatment is available.
Researchers haven’t unraveled the mystery of just how testosterone increases libido. It’s normal for a man’s sex drive to slowly decline from its peak in his teens and 20s, but libido varies widely between men. Also, sex drive changes within each man over time and is affected by stress, sleep, and opportunities for sex. For these reasons, defining what’s a “normal” sex drive is next to impossible. Usually, the man himself identifies a lack of sex drive as a problem. Other times, his partner may complain and send the man scurrying to his doctor for help or the partner may not consider the low sex drive to be an issue and they live happily ever after without an abundance of sexual intimacy.
In a large study of men in Massachusetts, about 11% overall said they had a lack of sex drive. The researchers then tested all the men’s testosterone levels. About 28% of men with low testosterone had low libido. These men were relatively young, with an average age of 47; older men might have worse sexual symptoms.
Low testosterone is only one of the causes of low libido. Stress, sleep deprivation, depression, and chronic medical illnesses can also sap a man’s sex drive.
Surprisingly, low testosterone by itself rarely causes erectile dysfunction, or ED. Low testosterone alone — with no other health problems — accounts for a small minority of men with erectile dysfunction.
Erection problems or ED are usually caused by atherosclerosis — hardening of the arteries. If damaged, the tiny blood vessels supplying the penis can no longer dilate to bring in the strong flow needed for a firm erection. Diabetes, high blood pressure, and high cholesterol are the three main causes of atherosclerosis and erectile dysfunction.
At the same time, low testosterone is a frequent accomplice to atherosclerosis in creating erectile dysfunction. About one in three men mentioning ED to their doctor have low testosterone. Experts believe that in men with other factors causing erectile dysfunction, low testosterone can strongly contribute, making a difficult situation even worse.
Strengthening the connection, low testosterone is linked in some way with many of the conditions that lead to erectile dysfunction:
• Metabolic syndrome
• Endothelial dysfunction
Although low testosterone isn’t known to cause them, the associations between other medical conditions and low testosterone can be significant.
Testosterone therapy improves sex drive and satisfaction with sex in many men. Treatment consists of injections of testosterone every 1-2 weeks, daily application of a testosterone gel, or the insertion of a testosterone pellet beneath the skin and then repeating the insertion every 4-6 months.
Most men with decreased testosterone levels can be helped. A simple blood test makes the diagnosis and treatment usually restores a man’s sex drive, energy level, and sexual performance.