The People's Perspective on Medicine

How Can a Man Tell if He Needs More Testosterone?

You would be surprised to learn how many women complain about their male partner's lack of sex drive. Do these guys need more testosterone? What else helps?

The FDA has been quite clear that it doesn’t approve of routine prescribing of testosterone, even if men have low levels of this hormone. Here is 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 conditions the FDA is referring to include genetic disorders, cancer treatment with chemotherapy, hypogonadism or problems with the brain structure called the hypothalamus. But what happens 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. 

And remember, Verisana Labs offers home test kits that will allow your husband to collect saliva for testing. This way he will get hormone information without coming up with excuses to avoid having his blood drawn. Include the promo code PEOPLE for the 20% discount. 

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

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I was diagnosed with hypogonadism in my early 40s. First took weekly injections, which were painful due to the size needle needed for the serum, and since have used a topical pump. It restored me not only sexually but in other ways as well. My levels are tested at least once yearly. My urologist and I strive for a number in the middle of the range. You don’t want it too high. To any male out there, please get your blood levels tested for free and total testosterone. Other hormones may need to be tested as well. There’s no need to suffer with low testosterone. I wish they had something like this that women could benefit from as well.

I have read that engaging in exogenous testosterone supplementation runs a clear risk of increasing the liklihood of developing prostate cancer earlier than might be otherwise expected. In this discussion today there is no mention of increased prostate cancer risk. Has the prostate risk concern been proven wrong?

What about women with low sex drive? Is there any way—natural or otherwise— to boost our sex drive? At my wits’ end.

Prior to wedding husband agreed to sex 3 – 4 times per week. He lied. As with many other topics he was just telling me what I wanted to hear to get me to marry him. Later, I asked him his thoughts about sex following our wedding, after he had refused to have sex with me. (He had just turned his back to me [at 3:00 in the afternoon!] and had gone to sleep.) He said, “I thought, ‘I’m glad I don’t have to do THAT any more!” One time, after we’d been married a year or so, I tried to show him where I wanted him to touch me. He refused to look. Dressed, we quarreled, and I yelled, “I thought you would know that when you married a human woman she would have genitals!” He put his hand over his eyes and said, “Yes, but I didn’t know I’d have to LOOK at them!” At the five year mark, during another discussion about sex, he said, “Well, I knew I’d have to do that three or four times a year.” I told him he didn’t marry me, he captured me.

He has ZERO sex drive. It took me 10 years to convince him a sex drive is a physical thing. Gradually, he came to understand, from listening to other men, that he was different. Bewildered, he said, “I never felt like that.” I won’t go through the physical, emotional and mental agonies I went through over the years. No “marriage”, no two-shall-become-one-flesh has ever taken place. Sex, to him, is like two dogs mating: only physical. He is my partner, not my mate. (I didn’t divorce him due to my religion.) We haven’t had sex since 1998. He did finally say, “I’m sorry,” and, “That must be awful!” after I vividly described the level of arousal and frustration I endured all day, every day, at my desk in my office.

I’ve finally found relative peace. I had one real marriage with a GREAT sex life, but to a man who was emotionally violent to my children. My current “husband”/partner of 35 years has a wonderful personality and an even-tempered disposition. We are friends. Sequentially, I have had it all, just not concurrently, as we all hope will be our lives. I’ve grieved the losses of the marriage I wanted and knowing I’ll never have sex again. I refuse to be unhappy. We have separate bedrooms so I can have a sex life, just without him. Sadly, he has no clue about the emotional, psychological, spiritual, and physical bliss he has missed. His life must taste like unsalted oatmeal.

I have been on and off of a testosterone compounded supplement for over 20 yrs. Recently we discovered that it may have been the cause for a very large prostate and very high PSA results. I stopped the testosterone and the PSA went down below midrange for normal PSA. I’m waiting to do another PSA test to see if it stays low or goes back up. In the mean time I have no energy, stamina, or sex drive/desire. My body has become very flabby. No muscle definition. I’m hoping to be able to go back on the testosterone supplement and regain some semblance of a normal life. I have been tested 3 times for prostate cancer, all negative. I wish they could come up with a testosterone replacement that would not affect the prostate.

It is my understanding that a man who has had prostate cancer should not take medication to raise his testosterone. Do not know if that is still the case.

L-arginine can be, and is, beneficial for lack of interest in sex. It provides the needed ingredients for a physical response if the desire can be stimulated. It does not do it all alone. The mind is needed also. Thru trial and error, I know that some non-brand products seem to have no effect, while others can work well. The best response I have found is from branded long-acting forms of the product at a dose of 1000mg twice a day. I have not tried a higher dose, but literature does point to a dose of up to 1000mg, 4 times a day, with 1000 mg, 1 to 2 hours prior to sex for play.

Men should get tested for testosterone levels. I did, and found that mine were below normal. Seeing a good endocrinologist will help. I had an MRI to check pituitary function and was placed on Androgel. For me, it has worked well. It is no magic bullet, but for me it has improved libido and helped me maintain a positive outlook.

I have been getting testosterone shots for years based on my wife’s complaint about my low libido. Yes, they do help. They help a lot! Even my doctor originally didn’t think I needed them; he thought I was depressed. I objected loudly to that diagnosis, and I demanded a blood test before he cooked my noodle. Sure enough, I had low testosterone, like pre-teen levels of low. So on the shot I went. The shots have not only helped with libido but also have gone a long way towards leveling my moods. The Mrs. believes I’m more calm, more patient, but much more driven and focused.

A word of caution about getting the shots. It takes awhile to figure out the dosage for each guy to get them into a therapeutic level. Some men respond to low doses. I worked with the doctor as we determined my body simply needed to exist at the higher end of the normal range in order to get the benefits. Take the time to work with a practitioner who doesn’t just get you into ‘normal’ range but will help you get to feeling normal too. And monitor your levels with blood tests.

Shots sometimes come with side effects such as raising estrogen levels (which can be corrected with an all- natural pill), and thickening the blood (which can also be corrected by donating blood). Testosterone shots can also lower male fertility so if kids are in the future be sure to discuss this with your doctor.

Lastly, not about testosterone but rather to address low libido specifically. Not often addressed yet happening right under the noses of unsuspecting wives is a man’s viewing of pornography. Watching that stuff changes how the brain computes rewards from real physical touch to artificially induced. Porn kills natural libido in a man, and he eventually no longer desires his wife. Sometimes, low libido is due to this rather than a traditional medical issue. Keep this in mind.

I have heard it said that the brain is the most important sex organ. We are living in a day when men are inundated with alluring ads, commercials, and billboards to take a walk down pornography lane. Once they set foot on this path, they are paving the way for an activity which is frustratingly only superficially satisfying and quite addictive. A man may feel like he has freedom when he strays from his monogamous commitment when in reality he sinks further into selfishness and isolation. Sex is the crowning joy and fun of an intimate relationship. It can also be very stimulating and enjoyable apart from relationship but in the end leaves a person very lonely. I believe this problem has infected our population on an epidemic level.

Impotence has many causes; namely, obesity, diabetes, and a plethora of medications. Psychological issues such as excessive stress, loss, financial instability which can cause excessive anxiety, and depression (and psychotropics can cause impotence as well) are also root causes. So easy for doctors to just hand out pills that cause other health problems (testosterone, for example, can cause heart attacks, strokes and increased aggression) rather than deal with underlying causes. The medical profession in many ways are slaves to pharmaceutical industries which is why I really don’t trust them. It’s like waving a magic wand!

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