Low testosterone levels can cause a multitude of health problems; obesity, heart disease, osteoporosis, brain fog, lethargy, and even depression can all be traced to low testosterone levels. One aspect of this condition that is always challenging to treat, is the accompanying low libido that plagues many men. Many men simply lose their appetite for sexual activity. It is not that they consciously don’t want it, but most men in our culture have relied on a libido and a sex drive to be the motivator for sexual activity.
One couple in my office was discussing the frustration of living with a man with low libido. The woman lamented the fact that somehow, she had been moved into the “friend” zone without ever realizing it. She felt as if they were living like roommates and not lovers. They knew they still loved each other, but the sexual chemistry and energy between them was simply gone. Western culture is partly responsible for some of the difficulties in these situations. Women have been told that his libido and sexual desire is their responsibility. Many women make the mistake of assuming that if he is not interested in sex, it is somehow their fault. This is a common lie that women have been fed their entire lives (the same lie feeds into the erectile dysfunction dilemma as well).
Men are often bewildered because they don’t know what’s going on. They can’t figure out why they’re not interested. They have always relied on a sex drive to be the instigator of their sex life. They are often just confused as their partners. Many men describe how they’re feeling as seeing delicious food in front of them – they enjoy the sight and the smell but have absolutely no desire to eat it.
Many partners take it upon themselves to do something to make the man aroused so that he will respond sexually. Partners try various techniques – sexy talk, lingerie, suggesting favorite sexual activities – anything they can think of to stoke the flames of passion (usually to no avail). When these efforts fail, many partners can feel a whole host of emotions: isolated, lonely, angry, sad, bitter, and resentful, to name a few. Many men sense this and instead of reaching out, they tend to retreat to a cave of pain and confusion. I have had countless patients tell me that in these instances, their solution has been to withdraw. Instead of touching their partner, they avoid touch because they feel touch must lead to intercourse and they don’t want to start something they can’t finish.
The solution to this dilemma is unraveling several lies about sex that most of us have believed our entire lives. The first one is that we have sex when we are horny. This belief can get in the way of full autonomy of a sex life. Men have abdicated the decision-making about their sex life to their hormone levels. Instead of intentional, thoughtful, mindful nurturing of their relationships, intimacy is left up to circumstance, open schedules, and hormone levels. The key is for men to recognize that sexual intimacy is a path to stability, happiness in the relationship, and even self-esteem. It is fine for the adolescent or young man to be driven by hormones, but a mature relationship requires thoughtful preparation, intentional action, and selfless focus on our partner’s needs. Instead of waiting for hormone levels to make us horny to engage in sex, we need to intellectually make the decision that sex is good for our relationship and our quality of life.
The second thought I want to bring up is the idea that sex must be intercourse. With low testosterone/low libido, it can be very difficult for men to obtain a reliable erection. In this case, sexual activity needs to shift from a procreative style intercourse to playful, engaging, and pleasure-focused fun. I often tell my patients that the drive to have intercourse can often get in the way of spontaneity and connecting sexual activity. For example, I suggest guys break out the coconut oil and cover their partner head to toe in it and just start playing with each other’s bodies. Most couples are not trying to conceive during sex, so, while intercourse is always on the menu, perhaps it should be optional and not the primary focus. Erotic massage, sex games, intimate touch, manual stimulation, all these options can be very satisfying if we let go of our cultural beliefs of what sex must be.
So, how do we arouse a man with low testosterone? The answer is, we don’t. The most helpful goal is probably not arousal. The more helpful goal might be feeling connected, bonded, validated, approved, loved, understood, and appreciated. Arousal is wonderful, but it’s not necessary to fulfill these goals. Many couples will benefit from speaking with a therapist or sex educator/counselor to help navigate this transition to a broader understanding of sexual activity. While healthcare professionals focus on creating optimal testosterone levels and eventually higher libido, it is important to also stay focused on the core goals that sustain a relationship.
If you are experiencing symptoms of Low T, please contact us to schedule a free phone consultation. Our team of sexual health experts can help.