As much as we have learned about how the brain and body work together for sexual desire and appetite, there is still an incomplete understanding of the role of our sex hormones in fueling sexual desire. We know that it is common for some people to lose their desire for sex as they get older and their hormone levels drop. For sure, the pharmaceutical industry is banking on men thinking that their low sex drive is due to low T. But is this the answer?
What role does testosterone play in sexual desire and libido?
Testosterone is often thought of as the hormone that brings vigor and motivation to life. It works on the body to increase muscle mass and red blood cells, but also increases overall drive and competition. We know that when testosterone levels drop too low – for either men or women – they not only lose their sex drive and desire, but they also can become quite fatigued and even depressed. So then replenishing the testosterone should do the trick and bring back that sex drive, right? The answer is “yes”, and “no”.
Testosterone does not work alone.
Interestingly, doctors are finding more and more that testosterone doesn’t work alone when it comes to mood and sexual desire. Perhaps one of the most striking examples of this is in men receiving testosterone supplementation at the same time as receiving aromatase inhibitors to prevent the conversion of that testosterone into estrogen. There are actually some men who find that their testosterone levels are boosted to normal levels while their body’s production of estrogen is dialed way down – and after a certain drop in estrogen levels, their sexual desire disappears. If those same men are allowed to have conversion of their testosterone to estrogen and their estrogen levels rise to a certain point – bam! – their sex drive comes back.
Does Estrogen hormone work for sexual desire?
This question is a little trickier to answer since estrogen is made from testosterone – so very few people have estrogen in their bodies without testosterone. Even in women after menopause who are only receiving estrogen replacement, there is still testosterone being produced from the adrenal glands and other tissues. We do know, however, that some young women who take birth control pills have their sex drive completely disappear when their free testosterone levels drop as I described in this article. So it appears that estrogen alone is not the answer, although we still are unsure about the effects of synthetic estrogens (like the ones found in birth control pills) on the brain versus natural estradiol.
Estrogen is an important player in sex drive – but not alone.
This tells us that there is probably a combination of estrogen and testosterone working together to create sexual desire. Our hormones are always trying to balance out, and they are in constant communication with each other at the level of the brain as well as at the cellular level. Sex drive and sexual desire are complex and also involve a great deal of psychological factors as well, including how a person views sex, how they feel about themselves sexually, and how they view their partner and their sexual interactions with their partner. So despite the pharmaceutical industry looking for that one magic bullet for sexual desire, ultimately it’s going to come down to a combination of factors – even with hormones.
I have been having a LOT of trouble with my ability to become truly erect. It seems to have begun right after I found out that my (now ex) wife was cheating on me with several other men.
I have noted several things:
1) I don’t “feel emotionally UP” anymore.
2) I don’t “feel” the touch from a female as exciting as I once did.
3) Several times now… in the midst of sexual intercourse… I suddenly got this strange pain in the lower right side of my skull…. causing me to completely shut down sexually-physically… and the pain would remain for some time… slowly fading away over about 1/2 hours time.
4) My physically sensitivity to touch seems to have lessened dramatically as well.
Sometimes…. no matter what is done… my penis simply will not become erect. It is beyond frustrating, and leaves an utter feeling of degrading upon me… as a “male.”
I honestly don’t know what has happened to me. I used to be so happy with how ‘HARD/ERECT” I would become. Now I have a GF who is so beautiful in every way… and so very loving… and extremely patient with me about this… I want the best FOR HER, and she is NOT getting it with my body behaving this way. Thank GOD My mouth works just fine.
One other thing… I also know that IF I masterbate… I can become more erect, almost fully erect, but when I have an orgasm… it goes limp instantly and almost during orgasm at times.
I had a test done to check my T level… apparently it is normal he said…. but I honestly don’t feel he is being truthful with me about it. I have NOT been tested for my Est level.
Is there a test to measure both?
I would absolutely appreciated ANY help that could come from you Dr. Castellanos.
Thank you for listening…. I came to your site because you seemed more interested in the Depths of sexual relations.
Nicholas, although I cannot give advice here to someone who is not my patient, I can make some general observations. I don’t see any reason why a provider would lie to you about your testosterone level. If it is low, it just increases their business since they will now prescribe it for you (hopefully ruling out any other causes of low testosterone). You can certainly have both levels checked, but it doesn’t sound as if this is the issue. Typically, the estrogen level is not the problem and psychological issues will almost always trump any physical or hormonal issues. Psychological issues can create sufficient disconnect to blunt the sensations being received from the body to the brain, and that is probably what is happening – especially if it started right after you found out your ex was cheating. From there, the brain learns to be anxious/angry/disconnected/fearful or whatever else is going on with sexual arousal.
I would suggest that you look up a sex therapist in your area and start working with one as soon as possible (or as soon as you would like to start resolving this issue). Best Wishes.
I was injured on the job that gave me 4 bulging discs and cervical compression and have been taking morphine for pain. It dropped my testosterone level so low that I lost my sex drive completely. Then I met my wife and we’ve been intimate for the past 14 months 2-5 times a day. 6 months ago is when I was tested for low testosterone and put me on Testim. My sex drive kicked right back in the first time we met and I wasn’t taking anything for low testosterone. When I was put on it my sex drive feels strong but, no different than before. We are deeply in love so, would being so attracted to her have boosted up my testosterone level without taking anything? I’m really confused about this but, yet concerned? Thank you.
Mark, my point is that desire is dependent on many different factors with testosterone being one of them. That said, many people have strong sexual desire even with low testosterone levels, so it is known that testosterone is not the only thing affecting it. It’s unclear if you are asking about how to increase your testosterone naturally, which I wrote about (here), or if you want to know how you could have strong desire even with low testosterone levels? I think more often than not, low testosterone is an effect of something else going on in the body (stress, diet, lifestyle, lack of sleep, alcohol or drugs, etc) rather than the primary problem. Although I do hormone supplementation for my patients who need it, I am cautious giving testosterone just for symptoms of feeling tired and low sex drive when there is no muscle loss because there are usually other causes that need to be addressed instead. Giving testosterone may mask the symptoms without addressing the underlying cause.