An Effective Approach to Treating Male Sexual Problems

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Male sexual problems (also called sexual dysfunction) prevent a man or his partner from enjoying sexual activity. They affect around 31% of men and can happen any time in their lives. But the good thing is most of them are treatable.  Advanced technologies and methods have now made it easier for doctors to understand these issues, identify their causes and treat them. Testosterone replacement therapy (TRT) is one of the most prevalent methods used to treat male sexual problems related to low testosterone. It has helped millions of men around the world have sexual satisfaction again and improve their overall health.

In this article, we will discuss TRT in detail to help you understand the procedure better and determine whether you should have it or not.

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Common male sexual problems

The most common problems men face during sex are erectile dysfunction (ED), low sex drive, and ejaculation disorders. Erectile dysfunction is the inability to gain or maintain an erection during sex. While it is normal to occasionally have an erection problem, if you experience this issue more often, you may have ED.

A 1995 study showed that around 152 million men worldwide have this problem. It is predicted that ED will affect 322 million men in 2025. A man can have ED for multiple reasons, such as low testosterone, prostate disorders, type 2 diabetes, high blood pressure, and high cholesterol levels. Its treatment is designed based on its cause.

Reduced sexual desire or low libido is another common problem affecting 1 in 5 men. It is a loss of interest in sexual activities. It can be a temporary or long-term problem, depending on its causes. A man’s desire to have sex fluctuates throughout his life. So we cannot tell what the right or wrong level of libido is. If your lack of interest in sexual activities is distressing you, you should discuss this matter with your doctor.

Many problems can lead to low libido, such as hormonal imbalance, stress, relationship problems, mental health problems, and ageing. Ejaculation disorders, including premature ejaculation, delayed ejaculation, and retrograde ejaculation, are also found in men. Premature ejaculation means you ejaculate soon after starting sexual activity. Delayed ejaculation is ejaculating late. And retrograde ejaculation occurs when the ejaculate enters the bladder instead of coming out of the body. Relationship problems, anxiety, depression, stress, and medications are the general causes of ejaculation disorders.

Role of testosterone in male sexual function

Testosterone is the main male sex hormone involved in the development of secondary sexual characteristics. It plays a big part in several important functions, but its more prominent role is to fuel sexual performance.

Testosterone levels change throughout a man’s life, but they take a dip as you get older. That is why older men have lower testosterone levels than younger men. Sexual problems are also more common in older adults because they do not have enough testosterone to fuel their sexual activities.

Can lack of testosterone cause sexual problems?

Men need testosterone to develop the reproductive system, regulate fertility, and maintain all steps of sexual response. It is obvious that if they don’t have healthy testosterone levels, their bodies will not be able to function normally.

If this problem persists, they may develop sexual disorders and other medical conditions. It can reduce their ability to enjoy sex and impregnate their partner. That is why if your testosterone levels are below normal and it is influencing your life, you should seek medical assistance.

Low testosterone, also called male hypogonadism, can cause many other problems, including:

• Reduced bone mass and density
• Reduced muscle mass and strength
• Increased body fat mass  
• Loss of body and facial hair
• Hot flashes
• Sleep problems
• Enlarged breasts
• Testicular shrinkage
• Depression
• Mood swings
• Low energy levels

All these symptoms can disturb your relationships, health, and life in various ways. For instance, lack of energy, depression, and mood swings can reduce productivity and work performance. Enlarged breasts, testicular shrinkage, and low sex drive may reduce self-confidence and affect your romantic relationship.

Some men may not have any problem with low T levels, while others can be very disturbed due to it. If you belong to the second group, you should get your problem checked and start a suitable treatment soon.

What causes low T?

Men can be born with low T or develop it due to a medical condition, injury, or even treatment. The main causes of low T are:

• Testicle cancer or injury
• Brain tumour or injury
• Lack of thyroid hormones
• Genetic conditions (Kallmann syndrome, Klinefelter syndrome, etc.)
• Kidney or liver failure
• AIDS
• Obesity
• Drug abuse
• Alcohol
• Cancer treatment (radiotherapy or chemotherapy)
• Side effects of medicines

Doctors design low-T treatment based on its actual cause. For example, if obesity, drug abuse, or alcohol is causing this issue, you will most likely be asked to improve your lifestyle. Reducing alcohol intake, stopping drug abuse, and losing weight can help you restore your testosterone levels and eliminate associated symptoms.

Similarly, your doctor will prescribe you testosterone replacement therapy (TRT) if your low T is due to hormonal imbalance.

An effective approach

TRT is a hormonal treatment used to restore testosterone levels in men who are testosterone deficient. There are different ways to receive testosterone, such as injections, creams, gels, patches, pellets, and tablets.

Testosterone gels are one of the most preferred forms of TRT. Gel is rubbed with dry hands on shoulders or upper arms as directed by doctors. You should wait for it to get fully dried or cover the skin with a cloth before you have skin-to-skin contact with kids or a pregnant woman.

Testosterone has helped millions of men improve their sexual performance and treat low T-related sexual problems. 

Some men with sexual problems may decide not to have the treatment and live with changes in their sexual performance or desire.

Evidence

Many researchers around the world are studying the impact of TRT on sexual problems. Several studies suggest the treatment helps in improving sexual desire and erectile dysfunction.

In a 2016 study, researchers divided 470 old men with low T into two groups. One group used testosterone gel, while the other used a placebo for around a year. By the end of the research, men from the first group reported a consistent improvement in their libido, while men from the second group did not report any improvement.

A 2022 study examined the effect of long-term TRT on 183 diabetic men with low T. Researchers gave these men testosterone for a certain time period and gave a placebo to another group of 178 men. They concluded that testosterone significantly improved ED in the first group, while ED deteriorated in men from the second group.

Other benefits of TRT

TRT can reverse low T symptoms and improve overall well-being. Its common benefits are:

• Increase in bone mass and density
• Increase in muscle mass
• Improvement in mental abilities
• Better mood and energy levels

Risks associated with TRT

TRT rose in popularity from 2000 to 2013, but later some studies highlighted its side effects, like increased heart attack risk, making people rethink their decision to take testosterone.

However, recent studies show mixed results. More research is needed. It would be best if you discussed TRT effects with your doctor to determine whether it is safe for you or not.

There is no doubt TRT has some side effects, but a doctor will only prescribe testosterone if its benefits outweigh its side effects for a patient.

Some possible side effects of TRT are:

• Low sperm count (which may lead to infertility)
• Gynecomastia
• Acne
• High blood cell count
• Irritability
• Fluid retention
• Sleep apnea

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Getting help

Sexual problems are common among men, but most of them are treatable. Contact a doctor to diagnose the problem and its underlying cause to get started with the treatment.

Doctors usually have a physical examination and tests like testosterone blood test, MRI, bone density test, etc., to find out why you have this problem. They explain treatment options once the cause has been diagnosed.

At Balance My Hormone, we offer solutions to sexual problems caused by low T. You can reach out to us via phone to discuss your symptoms and share testosterone test results. Our experts are more than happy to assist you in finding a suitable low T treatment and improving your overall health.

Resources/Further reading/References/Bibliography/Scientific studies 

Rastrelli, G., Corona, G. and Maggi, M., 2018. Testosterone and sexual function in men. Maturitas, 112, pp.46-52.

Rizk, P.J., Kohn, T.P., Pastuszak, A.W. and Khera, M., 2017. Testosterone therapy improves erectile function and libido in hypogonadal men. Current opinion in urology, 27(6), p.511.

Surampudi, P.N., Wang, C. and Swerdloff, R., 2012. Hypogonadism in the aging male diagnosis, potential benefits, and risks of testosterone replacement therapy. International journal of endocrinology, 2012.

Khera, M., Bhattacharya, R.K., Blick, G., Kushner, H., Nguyen, D. and Miner, M.M., 2011. Improved sexual function with testosterone replacement therapy in hypogonadal men: Real‐world data from the Testim Registry in the United States (TRiUS). The journal of sexual medicine, 8(11), pp.3204-3213.

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