Testosterone/Low Libido Questions

[Asshungry]

I realize that I'm late to the thread, but I'll chime in. In my experience we have to look at the male libido as a system, and not a "thing". There are a lot of things that influence each other, and sometime cause each other. I am in my late 40s. I have low testosterone, am a bit overweight, and suffer from sleep apnea. Low testosterone causes weight gain, apnea causes weight gain, weight gain causes apnea and lower free testosterone. It's a cycle.

Among the things that I have struggled with are sex drive, overall sense of well being, fatigue, motivation, and a few other things. Any one or more of those symptoms can have more than one cause. My approach to managing my health is based on the "body as a system" for lack of a better explanation. It has included getting treatment for the apnea, using a prescription 3% testosterone creme, diet and exercise. I backslide on the diet constantly, unfortunately.

This road has taken more than a year. Insurance, overbooked Dr's, waiting for test results, repeating tests, waiting for another visit to the dr all wasted weeks and months.

Any one of the treatments I'm using (apnea, testosterone) might be contributing to my overall improvement in mood, sex drive, and energy. I went on a strenuous backpacking trip this summer and lost 10 lbs. Most of that was probably water, but after getting back my wife didn't know what hit her in bed Driven and hard as steel like I havent felt in ages. I think that by approaching the body as a system I have improved the outcome.

Best of luck to you.

this is a very good point. My Dr. wouldnt start me on T therapy until I had a sleep study. Low and behold I had severe sleep apnea. Now thats being treated as well as the T therapy and life is good. Also shedding a few pounds, feel better all the time.

 

[fire_breeze]

So I have to admit being confused by what I hear here and what the doctors are telling me. But I appreciate all the support.

The thing is that we are not doctors, nor are we specialists. If the doc at the sexual clinic is a specialist, then by all means, follow his advice. We do not have your medical history, they do. It's easy for us to say "get this checked out and if it's X then you have Y", and completely discount the numerous factors that could explain X. If they are not looking at your free T, or aren't too concerned with it, neither should you.

In my experience, stay away from the interwebs, as the information is stupid conflicting and is usually on the 'conservative' side. If I had a question about my thyroid, I asked my docs. They went to medical school for 8 years plus another 4 years in specialised medicine. Yes, you should take charge of your health - particularly if the symptoms do not subside, then by all means, persist - but remember, you also do not have the training that they did.

Good luck .

 

[njlauren]

I have had a mild case of Gynecomastia since age 11 (now 55) and not from being over weight. Have had low T for the past ten years (181 free T, E levels high side of normal for a man) and have been on various courses of treatment during those years ranging from creams, gels, injections, under arm applied (axiron) stuff, and back to creams, all while under various doctor's care. My levels were in the 500-600 range. What were my results? Well, sometime during the T injection phase, I developed painful, achy, and at times itchy breasts 2 1/2 years ago which resulted in me now having to wear a bra. Yup, a bra, and its a 38C. I even went for a fitting. Not exactly what I had in mind. The up side is that my wife and I go bra shopping together and in the evening she removes mine and I remove hers. Lucky for me she is good with it or it would cost me an operation for boob removal which is something I do not relish. She actually thinks its funny telling me that now you know what I have to put up with.
What has T done for libido? Not much that I can tell. My sex drive was never stellar and T hasn't done much in the way of urge that I can tell. Also while on T, I tend to be moodier in terms of aggression.
With boob growth (also with slightly diminished urine stream, climbing PSA) and a lengthy conversation with my Dr along with further blood work, I decided to get off the T for 6 months and see what happens. In March I will have my levels checked again.
So now, I have been off for 2 months. What do I notice? A slightly reduced urge to merge, much slower facial hair growth, urine stream is great, more even mood and less aggressiveness (not as moody), and no depression whatsoever. I actually feel pretty good.

I guess my advice is that Testosterone therapy is nothing to play with. Do discuss it with your doctor and get a 2nd opinion if you need. It works for many men, but not for me. I wasn't expecting puberty of the female sort at my age.

The breast growth isn't surprising, it is ironic, but what happens is the body sees the induced testosterone and in response actually starts creating more estrogen. Body builders who play around with steroids often end up with shrunken testicles and penis's and breast development because of the effects of the steroids/T. It is why self med'ing when it comes to hormones is playing russian roulette, because the endocrine system is complex. One of the problems with going to GP's with issues related to hormones is they aren't experts in the endocrine system, and quite frankly a lot of what is cutting edge in research into hormones hasn't passed into the medical system yet. For example, there is significant work out there now, not just 'crackpots' like Suzanne Somers (I put it in parentheses for a reason), that indicate that a lot of the problems with aging are caused by the decrease in hormones as we age, and that a lot of the diseases of aging may be caused by the lack of hormones (think about it, hormones in men start declining in our 30's, by our 40's they can be down by 40% or more, when people lived to be 35 or 40, no big deal, but now living into our 70's and 80's, it is huge). Everyone is also different, when I was on HRT I was on what was considered a starter dose, but my estrogen levels were near the top of the scale, and I developed very rapidly and to an amount my endo didn't believe given my age, but I was an outlier, but still, everyone is different.

I agree totally that people should seek professional health, but don't assume that run of the mill doctors are really all that knowledgeable, they aren't, with things like hormones it pays to see an expert, rather than someone reading off a chart. Among other things, the whole 'this is in normal range' means very little, because that is a chart someone cooked up using averages based on samples, but it says only within their sample this is within average, and it also doesn't say how someone reacts to those levels. One guy might be in the lower end of the normal range, and be perfectly fine, have decent drive, etc, another guy might have those levels and be a slug, because everyone reacts differently to a level of hormones (see my section above, I happen to react strongly to hormones of either kind). Experts among other things tend to keep up with current literature and trends.

I also agree with those saying this is a total systems thing, any endo worth their salt will tell you that. Besides the fact that it boosts testosterone levels, exercise also increases blood circulation which in turn can help with ED. Being overweight fouls up the endocrine system as well, fat (or lack thereof) does strange things with hormones, if women go below a certain percentage of body fat, they can stop menstruating because they can't synthesize hormones without the fat, and so forth. Overweight is associated with diabetes, that fouls up the circulatory system....and yep, mental health affects the whole thing. Lack of sex drive isn't just physical, if someone is depressed you could shoot them up with vials and vials of T, and their sex drive might not be there, because sex drive is a major function of the brain.

Re-reading the OP's post, I think it is important to work on the sex drive and ED from a physical basis, and obviously eating healthy and exercising isn't exactly going to hurt, but you also may want to see a counselor if you have self esteem issues and such, you could be depressed as well, or have other issues.

I think the total systems post is brilliant, because it is that, a total systems, and I think my advice would be to pursue it from multiple angles and see what happens. Yeah, TV sells the idea that T is a wonder drug, like the ED meds like Cialis do, but the reality is unless that is the only issue, it isn't going to solve it. One of the things I know in my own case is that my diet and exercise issues are caused by mental health issues, of stress and depression (not to mention brutal work hours and commuting) and other factors, and again, it is a big circle. The problem with many doctors is guy will come in with ED, and say 'okay, take Viagra' without doing that, or they will have a guy complaining of low sex drive who is overweight, and say "diet and exercise', without looking at his T levels as well (low t levels leads to putting on weight), or without asking 'hmm, maybe this guy has low sex drive and is overweight because he is depressed'). I would approach it from all angles, and see what happens.

 

[summiter1]

Pink...is he getting enough exercise? The medicine etc. sounds like a good start but the body needs exercise to stay in tune so to speak.

 

[HeavyFuel]

I blew this response.

 

[HeavyFuel]

The breast growth isn't surprising, it is ironic, but what happens is the body sees the induced testosterone and in response actually starts creating more estrogen. Body builders who play around with steroids often end up with shrunken testicles and penis's and breast development because of the effects of the steroids/T. It is why self med'ing when it comes to hormones is playing russian roulette, because the endocrine system is complex. One of the problems with going to GP's with issues related to hormones is they aren't experts in the endocrine system, and quite frankly a lot of what is cutting edge in research into hormones hasn't passed into the medical system yet. For example, there is significant work out there now, not just 'crackpots' like Suzanne Somers (I put it in parentheses for a reason), that indicate that a lot of the problems with aging are caused by the decrease in hormones as we age, and that a lot of the diseases of aging may be caused by the lack of hormones (think about it, hormones in men start declining in our 30's, by our 40's they can be down by 40% or more, when people lived to be 35 or 40, no big deal, but now living into our 70's and 80's, it is huge). Everyone is also different, when I was on HRT I was on what was considered a starter dose, but my estrogen levels were near the top of the scale, and I developed very rapidly and to an amount my endo didn't believe given my age, but I was an outlier, but still, everyone is different.

I agree totally that people should seek professional health, but don't assume that run of the mill doctors are really all that knowledgeable, they aren't, with things like hormones it pays to see an expert, rather than someone reading off a chart. Among other things, the whole 'this is in normal range' means very little, because that is a chart someone cooked up using averages based on samples, but it says only within their sample this is within average, and it also doesn't say how someone reacts to those levels. One guy might be in the lower end of the normal range, and be perfectly fine, have decent drive, etc, another guy might have those levels and be a slug, because everyone reacts differently to a level of hormones (see my section above, I happen to react strongly to hormones of either kind). Experts among other things tend to keep up with current literature and trends.

I also agree with those saying this is a total systems thing, any endo worth their salt will tell you that. Besides the fact that it boosts testosterone levels, exercise also increases blood circulation which in turn can help with ED. Being overweight fouls up the endocrine system as well, fat (or lack thereof) does strange things with hormones, if women go below a certain percentage of body fat, they can stop menstruating because they can't synthesize hormones without the fat, and so forth. Overweight is associated with diabetes, that fouls up the circulatory system....and yep, mental health affects the whole thing. Lack of sex drive isn't just physical, if someone is depressed you could shoot them up with vials and vials of T, and their sex drive might not be there, because sex drive is a major function of the brain.

Re-reading the OP's post, I think it is important to work on the sex drive and ED from a physical basis, and obviously eating healthy and exercising isn't exactly going to hurt, but you also may want to see a counselor if you have self esteem issues and such, you could be depressed as well, or have other issues.

I think the total systems post is brilliant, because it is that, a total systems, and I think my advice would be to pursue it from multiple angles and see what happens. Yeah, TV sells the idea that T is a wonder drug, like the ED meds like Cialis do, but the reality is unless that is the only issue, it isn't going to solve it. One of the things I know in my own case is that my diet and exercise issues are caused by mental health issues, of stress and depression (not to mention brutal work hours and commuting) and other factors, and again, it is a big circle. The problem with many doctors is guy will come in with ED, and say 'okay, take Viagra' without doing that, or they will have a guy complaining of low sex drive who is overweight, and say "diet and exercise', without looking at his T levels as well (low t levels leads to putting on weight), or without asking 'hmm, maybe this guy has low sex drive and is overweight because he is depressed'). I would approach it from all angles, and see what happens.

Pretty much. Me, much stress over the past 30 years, more than I care to go over. Not over weight for my build and height and get plenty of exercise and no depression. BP is perfectly normal too. Diet is healthy and void of junk type food. I think the main factor, at least for me, was the stress I had. Much of the T work I had was with an endocrinologist as well. Seems that my father also had the same T issues so perhaps, genetics might play a role. He did live to the age of 88.

 

[DrHappy]

Gynecomastia is easily avoided by taking a small dose of Arimidex to lower estrogen levels if they get too high. Monitoring estrogen levels should be a part of any testosterone therapy. High estrogen levels can also block the beneficial effects of testosterone, so that you may have low libido, low energy, water retention, and decreased muscle tone and mass. Estrogen levels that are too low aren’t good either. Estrogen can get too low for some men with low testosterone, and men undergoing testosterone treatment who take too much Arimidex.

Seeking competent testosterone treatment can be a frustrating experience (as you have found). There seems to be a stigma among the many doctors, and many are simply not knowledgeable about this subject. The internet can be a great resource for learning on your own, but as I’m sure you already know, there is lots of misinformation as well.

As I mentioned to the original poster, it may also be worth asking about HCG as either a replacement for testosterone, or to be taking along with testosterone. This will stimulate the testicles and prevent atrophy, and may help with any fertility issues later if you want to have children. I don’t know about its availability in NZ.

 

[HeavyFuel]

DrHappy, that is good to know. I have done some reading on that very subject the last few days and is something I will discuss with the Dr. Next blood work for me, will include estrogens as well.
Again, thanks!

 

[Freebird49]

re: testosterone/low libido issues

It could be a lot of things. Does he exercise regularly? By exercise I mean lift weights? Weight training is a good way to boost testosterone. Medical intervention may be okay as long as it is a last resort. I don't know about the women but as men age we deplete magnesium and zinc from our bodies. He should look for a good supplement with safe amounts of zinc and magnesium.

 

[PinkLace5]

Speaking from my own experience, please be patient with him, it likely is not about you, when the hormones are out of whack it is like you lost your best friend, your parents and your testicles in the same weak, it feels like you are encased in some sort of goo, life goes by slowly, and about all you want to do is throw yourself on the sofa and sit there and vegetate, and Angelina Jolie could walk in in tight leather clothing and you would tell her to get her ass out of the way of the tv......

I apologize for how long it's taken me to write back. Life got a bit hectic! NJLauren, this was the most comforting thing to hear/read. It's very hard to stay positive when this has been an ongoing issue over a long period of time. My boyfriend switched from the gel to testosterone pellets, and unfortunately, there was little to no change. Although the gel didn't create a huge change, there was enough of a change (within a month--which I know it takes longer to fully work) for me to know that the testosterone was causing a larger part of the problem. I'm hoping with the new insurance that we're getting that he will be able to go back on the gel. I wish he would consider the shots, but he refuses, and I respect that.

I'm no Angelina Jolie, but I'm attractive and fortunate enough to have a nice shape despite my sweet tooth . It's very hard to dress nice or wear lingerie and get little to no response. Or, when I'm changing in the same room, and his eyes stayed glued to the TV. My self-confidence drops pretty low. It's been so helpful to read everyone's experiences and suggestions.

Some people have asked about his diet. It isn't good. It isn't necessarily horrible, but he's overweight. When I've broached the subject with him, I always start off by telling him that it has nothing to do with looks (he's an attractive guy), but I'm very concerned about his health. He loves snacking and is an amazing cook. He loves fast food and a lot of cheese. He used to work out at the gym but stopped. I think he felt frustrated because nothing was happening. Hopefully, the medicine will change this. His endocrinologist appointment is coming up. The endo said that if he didn't lost any weight within three months on the medicine and exercising that she wanted to put him on additional medicine and a strict diet plan (he had borderline high liver levels--whatever that means). Our therapist suggested we have another couple's session soon. I'm hoping therapy is helping him as well regarding his insecurity issues.

Gagginforit, I hope you continue to look for other medical opinions. Personally, I have medical/digestive issues, and I have dealt with a lot of doctors who refused to offer treatment options because my blood tests didn't show anything conclusively. After a lot of frustration and tears, I kept pushing that something was wrong. I found out that I have a lot of food allergies and drastically changed my diet. I feel so much better. I know the situation is different, but it's so important to keep looking for answers. You WILL figure this out.

 

[DrHappy]

Pinklace5,

Do you know his current levels of testosterone and estrogen now that he’s had the pellets implanted? The testosterone levels may need adjusting. If his estrogen is too high, then he won’t feel the positive effects of the increased testosterone.

 

[Nausea]

Darling, believe me, if you don't have sex your relationship is going nowhere.

 

[PinkLace5]

Pinklace5,

Do you know his current levels of testosterone and estrogen now that he’s had the pellets implanted? The testosterone levels may need adjusting. If his estrogen is too high, then he won’t feel the positive effects of the increased testosterone.

He had the pellets implanted about two and a half months ago. His urologist told him to come back for an appointment to check his levels in three months. Because I saw a change in him since using the gel, I asked him to call the doctor, but he insisted that the doctor couldn't do anything. He seemed to be as he was before he started T therapy. I told him if anything, it would be helpful to know if his levels were low. Thankfully, he finally listened to me and made an earlier appointment. I believe it's this week. I'm going to tell him to mention getting both his testosterone and estrogen levels checked. He went from 250 to around 600s (don't remember the exact number) from using the gel. The urologist was willing to increase the dose if necessary. I still don't understand the difference between the different types of testosterone, but I'm working on it.

 

[rider81]

He had the pellets implanted about two and a half months ago. His urologist told him to come back for an appointment to check his levels in three months. Because I saw a change in him since using the gel, I asked him to call the doctor, but he insisted that the doctor couldn't do anything. He seemed to be as he was before he started T therapy. I told him if anything, it would be helpful to know if his levels were low. Thankfully, he finally listened to me and made an earlier appointment. I believe it's this week. I'm going to tell him to mention getting both his testosterone and estrogen levels checked. He went from 250 to around 600s (don't remember the exact number) from using the gel. The urologist was willing to increase the dose if necessary. I still don't understand the difference between the different types of testosterone, but I'm working on it.

It's not enough just to check the testosterone level. It's also important to check the free testosterone level, especially if you are an active, athletic male. A lot of GPs ignore the free testosterone, which is a big mistake.

 

[jaketen2001]

i heard one time

I heard one time on the radio a story of a couple in a similar situation. He was not interested/could not perform. It turned out he had been sexually abused as a youth. It was clear to her the he loved her. The woman's voice cracked over the airwaves as she said this because she knew it was true. He did some therapy and it worked. Hope this helps.

 

[gagginforit]

I heard one time on the radio a story of a couple in a similar situation. He was not interested/could not perform. It turned out he had been sexually abused as a youth. It was clear to her the he loved her. The woman's voice cracked over the airwaves as she said this because she knew it was true. He did some therapy and it worked. Hope this helps.

Did it happen to mention if he could perform by himself and just not with another person? Or could he not get erect at all?

 

[gagginforit]

Well I got the patches. I'll start them tomorrow.

I also plan to look into therapy. I was abused as a child, and although I wasn't traumatised by it I suppose I would be naive to think it didn't have any effect on me.