How Can a Man Tell if He Needs More Testosterone?

Historically, the FDA has been quite clear that it does not approve routine prescribing of testosterone, even if men have low levels of this hormone. Here was the official word from the feds: “None of the FDA-approved testosterone products are approved for use in men with low testosterone levels who lack an associated medical condition.” The FDA has worried that if men take testosterone, they will experience a serious risk for cardiovascular complications. In other words, men who take more testosterone will be vulnerable to heart attacks and strokes.

The medical conditions the FDA is referring to above include genetic disorders, cancer treatment with chemotherapy, hypogonadism or problems with the brain structure called the hypothalamus. But millions of men experience below normal levels of testosterone for their age. Are they really at risk for cardiovascular complications?

That’s the question this reader asks:

Q. Do you have more details about the use of testosterone replacement in men? My understanding is that a relatively recent large-scale study showed that men using testosterone replacement therapy did not have more cardiovascular risks. That has long been the concern of the medical community.

A. Earlier this year, the FDA revised the required labeling for testosterone products prescribed for men with low hormone levels. The agency said drug companies should remove the Boxed Warning about adverse cardiovascular outcomes from their testosterone labels.

This is based on the outcomes of the TRAVERSE study (New England Journal of Medicine, June 16, 2023). It showed no difference between testosterone and placebo when it came to risks of heart attacks, strokes or stents.

Here is what the researchers discovered in their won words:

“We conducted this randomized, placebo-controlled trial to address uncertainty as to whether testosterone-replacement therapy in middle-aged and older men with hypogonadism increases the risk of cardiovascular events. We included men with established cardiovascular disease or multiple cardiac risk factors who would be most vulnerable to an increased risk of adverse cardiovascular outcomes. Among 5198 patients who received testosterone or placebo for a mean duration of 22 months, testosterone-replacement therapy was noninferior to placebo with respect to the incidence of major adverse cardiac events.”

What If A Man Has Low T and No Libido?

What if a man’s testosterone levels are so low that he has no interest in sexual intimacy? That is the question this woman is asking.

Does Husband Need More Testosterone?

Q. My husband has a really low sex drive. He rarely initiates any intimate contact. When I try to interest him in a romantic evening he comes up with one excuse or another. He makes me feel undesirable.

I suggested that he might want to ask his doctor to test his testosterone levels but he hates getting stuck with a needle. That was a nonstarter. Is there anything he could take to boost his testosterone naturally? Some of the ads on the web seem too good to be true.

A. We would caution against trying products advertised on the Internet. There are a lot of scam artists out there and you have no way of knowing what is really in such products.

First, we would like you to know that you are not alone. We have heard from hundreds of women who, like you, are frustrated that their husbands or boyfriends have little to no sex drive. Many feel so rejected that they seek ways to suppress their own sex drive. We think that is terribly sad.

Stories of Frustration:

Sharmaine in South Carolina shares a similar story:

“In the past three years, my husband and I may have had sex 10 times. He says he’s always had a low libido. Even while we’re having sex, he’s not necessarily enjoying it because he has zero desire. The only reason we’ve even had sex at all in the past few years is because I initiated it and because he wants to make me happy.

“It bothers me that he doesn’t try to do anything to increase his sex drive or his desire. He talks a good game but never initiates any sexual contact. It’s to the point where I cry after we’re done and he’s asleep because I know he doesn’t really want to have sex.”

Anonymous in Utah writes:

“I am married to the love of my life. We have known each other for more than 25 years. We started as friends and then the relationship became much deeper.

“Sex was never a problem. Then unexpectedly my husband began to avoid situations that might lead to physical intimacy. At first I blamed myself. I feared that I was less attractive than I used to be. My self esteem took a nose dive.

“Our relationship is suffering. I feel terribly lonely and cry myself to sleep.”

Here are just a few articles on this topic.

This article has 278 comments:

Seeking Ways To Suppress Sex Drive

There are almost 400 comments at the bottom of this article:

What Can A Woman Do To Kill Her Sex Drive?

As stated, we think that trying to deal with a man’s low libido by killing your own sex drive is tragic. We have some alternate suggestions.

Testing for Testosterone:

We understand that your husband is phobic when it comes to needles. He’s not the only one. Many people hate being stuck to get their blood drawn.

There is an initial test that could reveal his hormonal status and would not require a blood test. A company that underwrites our radio show, Verisana Labs, provides a Male Hormone Health Check using saliva samples. This test kit analyzes testosterone, estradiol, progesterone, DHEA and cortisol. Here is a link to learn more. If you use the promo code PEOPLE, you will get 20% off your first order.

Once you and your husband get the results back, you will have a better sense whether his problem might be related to his hormone levels. He can take that information to his physician for followup. Whether he needs more testosterone will be totally up to his doctor.

Enhancing Sex Drive Without Taking More Testosterone:

Even if your husband’s testosterone levels are low, he may be able to improve his sex drive naturally. Here is a link to an article about bright light exposure and more testosterone. As hormone levels went up so did sexual interest.

How to Improve Men’s Sex Drive Without Drugs

Getting your husband outside on a sunny day could be beneficial for all sorts of reasons. Exercise is good for the heart, the brain and the sex drive.

To learn more about exercise and diet we would encourage you and your husband to take a few minutes and listen to our free podcast with Dr. John La Puma. Here is a link:

Show 975: Boosting Testosterone Naturally

You can listen to the streaming audio by clicking on the green arrow over Dr. La Puma’s photo or you can download the free mp3 file and listen on your computer, phone or tablet. Dr. La Puma describes symptoms of low T and provides nondrug approaches for getting more testosterone circulating in the body.

A number of laboratories offer testosterone testing. They include Quest, Labcorp On Demand and Everlywell. This way he will get hormone information without coming up with excuses.

Share your own experience with hormones and libido in the comment section below.