Estrogen therapy increases sex hormone binding globulin and, like aging men, this reduces the amount of free, active testosterone in the body. One treatment available for many of these problems is spironolactone, a special type of diuretic (water pill) that blocks the action of male sex hormones. It’s "pretty clear" that low doses of testosterone can improve libido for post-menopausal women experiencing hypoactive sexual desire disorder (HSDD), which means lack of desire without some other underlying cause, Kurtzer says. While women have smaller amounts than men, testosterone plays an important role in regulating the menstrual cycle, maintaining bone density and muscle mass, and enhancing cognitive health, mood, sexual function, and energy. Hall scheduled an appointment with a specialist, and in 2024 started testosterone replacement therapy (TRT)—receiving regular small doses of the hormone that’s almost synonymous with male health.
Feeling unusually tired (fatigue), even after enough sleep, is a common symptom of low testosterone4. Think of it as one of the body’s main 'performance regulators.' If you are concerned about low-T symptoms, or if you've tried therapies that didn't work, talk with your primary care doctor or urologist. In rare cases when neither therapy works, we can consider increasing the FSH level as well with injections of the FSH substitute hMG.
Variations in these hormone levels could change how much (or how little) you want to have sex. Sex hormones like testosterone and estrogen also play a big part. Many things affect your sex drive, including your physical health, emotional well-being, and your relationship. Your sex drive, or libido, is what makes you want to have sex. You have low testosterone when your testicles don’t produce enough of this sex hormone. If you have low testosterone, it could affect your sex drive. Hone-affiliated medical practices are independently owned and operated by licensed physicians who provide services using the Hone telehealth platform.
If you think you may have symptoms of low testosterone or excess testosterone, talk to your healthcare provider. Testosterone levels in males naturally decline with age. The symptoms of low testosterone vary based on your age. In female adults, high levels of testosterone may be a sign of polycystic ovary syndrome (PCOS). High levels of testosterone in female infants may lead to enlargement of their clitoris that can look almost like a penis. Excess testosterone in male children can lead to precocious (early) puberty, which is when puberty begins before the age of nine.
But are those risks only relevant to ‘roided-up bodybuilders? It’s pretty clear, for example, that serious testosterone abuse may lead to heart and liver issues. Hardcore testosterone proponents often don’t present the potential downsides to taking T. Some of this variation likely comes down to the fact that each of our bodies react to testosterone a little differently.
Granted, there’s a ton of active debate among medical experts about exactly what risks testosterone might pose, and in what contexts it may be risky. "It is true that testosterone is related to libido in many men," says Sun. According to several practitioners and researchers, it’s actually the result of over a decade of effective direct-to-consumer advertising by the makers of testosterone gels and creams, pills and patches, injections and under-the-skin implant pellets. However, it’s important to note that even drinking one or two drinks daily doesn’t provide benefits to health and longevity, as has been believed for years. The Centers for Disease Control and Prevention recommends that males drink two or fewer alcoholic beverages daily. Over a long period of time, excessive amounts of alcohol can reduce your sex drive and lead to erectile dysfunction. It may also cause anxiety about sexual performance, which could lead to issues with erectile dysfunction, reduced sexual desire, and avoiding sex altogether.

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