Category: Libido

Testosterone: Men and Ageing

Testosterone is a hormone found in both men and women, although men have much higher levels of testosterone than women. Testosterone plays an important role in the feeling of sexual interest and desire – i.e. libido in both men and women.

During puberty in a male, testosterone influences the development of the mature male sex characteristics including: the growth of the genitals (penis and testicles), deepening of the voice due to growth of the larynx and vocal cords, growth of facial, body and pubic hair, development of male pattern hair line (including varying degrees of baldness), the growth of muscles and broadening of the shoulders, an increase in aggressive characteristics, an increase in sexual interest and an increase/thickness of secretions in the skin glands (the reason for acne being more common in men).

Some of the following facts may surprise you:

More sexual activity (by oneself or with a partner) can result in a slight increase in a man’s testosterone levels.

Testosterone levels in healthy men remain at about the same level with increasing age.

Another way to say this:

‘Ageing has only a minuscule effect on testosterone levels in men’.

A recent study (1) calculated the average decline in serum testosterone is 0.5% per year – lower than has been previously claimed (0.8-2% per year).

A marked reduction in healthy mens’ testosterone levels occurs only after the age of 80 years.

A reduction of testosterone levels in men is associated with co-morbidities (co-existing health problems) such as:

  • Obesity
  • Depression
  • Cardiovascular disease

And also:

  • Heavy alcohol intake
  • Severe disruption to sleep patterns
  • Some drugs – e.g.1) opioids and 2) certain statins (cholesterol lowering drugs) particularly atorvastatin
  • Loss of a spouse/social defeat/recent fatherhood
  • Stopping smoking – please don’t think this is a good reason to keep smoking. Apart from causing damage to many parts of the body and increasing the risks of many cancers, smoking also has long term and DIRECT negative effects on erections.

Further research is required to understand the role that ‘co-morbidities’ play in the levels of testosterone in men as they age.

There is an important and very exciting Australia wide study (‘T4DM’) being conducted at present for men over 50 – to determine whether or not testosterone and lifestyle changes/diet can influence the development of Type 2 Diabetes in men with low testosterone levels and signs of ‘pre-diabetes’. This study is being conducted by world leaders in the field of mens’ health, diabetes and obesity. Men who become engaged with the T4DM study have free access to weight loss services and personalized medical checks. Here is the link: T4DM study.

If you are interested in being involved in this study, it is important to register soon. ‘If you make haste, you will have less waist!!’ With weight loss and an improved lifestyle, you are likely to also notice improvements in your sexual functioning.

If you need any help to improve your sex life, then do feel free to consult with me, Dr Marie Tudor. I can assess your situation from a medical, psychological and relationship perspective and then offer strategies and solutions suited to your needs.

Reference:

Age-specific population centiles for androgen status in men

D J Handelsman, B B Yeap1,2, L Flicker1,3, S Martin4, G A Wittert4 and Lam P Ly

European Journal of Endocrinology (2015) 173, 809-817.

T4DM study

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sex therapy can aid with mismatched sexual desire or low libido

Libido: Mismatched Sexual Desires

The desire for sex (libido) is complex and influenced by psychological, biological, relationship and cultural factors.

To have the motivation to be sexual, a person needs:

  • Drive – the biological component of sex drive (libido) dependent on well functioning ‘neuroendocrine’ (the connection of hormonal and nerve pathways) and anatomical systems.
  • Motivation – the psychological component of sex drive – including mood (affected by stress and psychological issues), the state of the interpersonal relationship with the partner and the general social context.
  • Wish – the cultural component – The cultural beliefs, values, rules and ideals about sexual expression that influence the individual.

(Levine, S.B., 2003)

The DRIVE and MOTIVATION components of sexual desire can be adversely affected by:

  • Any significant psychological issue (e.g. depression)
  • Conditions affecting the hormonal pathways that support libido (e.g. conditions that lead to low testosterone levels, an under active thyroid or high levels of prolactin)
  • Many chronic illnesses
  • Many medications and recreational drugs
  • Lifestyle factors and the common stresses of everyday life, such as large workloads, long working hours, family needs/pressures, technology intrusions (mobile phones, computers, social media, TV) can all influence sexual desire.

The relationship of a couple will inevitably evolve over time.

Interests, beliefs and expectations regarding intimacy and sex can change for each in the relationship. As time goes by there is a challenge for a couple to keep the interest in sex alive. Some couples slip into a ‘rut’ of sexual styles or behaviours that can soon become predictable and boring. Even finding time together can be an issue when life becomes busy, when childrens’ needs take priority or when couples forget to invest time in their relationship in favour of individual or family pursuits.

Is a lack or mismatch of sexual desire affecting your relationship?

Sex therapy can be a way to address some of these issues. Please feel welcome to meet with me so that I can assess your particular case and work with you and your partner to find solutions to support you both and the needs of your relationship.

For more on desire concerns see here.

 

Reference:

Levine, SB The Nature of Sexual Desire: A clinician’s perspective’

Archives of Sexual Behaviour – 2003; 32: 279-85.

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The low down on the latest libido drug for women, sometimes referred to as female Viagra

USA: The FDA approves first ‘libido’ drug for women

The latest news about a new drug recently approved in the USA to help women and their sexual desire.

Since the availability of Viagra for men more than 10 years ago, many women have been hoping for a treatment for their sexual needs. On August 18th 2015 the FDA (the U.S. Food and Drug Administration) approved ‘Addyi’ (flibanserin) to treat ‘acquired, generalised hypoactive sexual desire disorder’ (HSDD) in premenopausal women.

The quest for the approval of flibanserin took about five years, 2 rejected FDA applications, a change of drug company ownership and the inception of an online action group called ‘Even the Score’ (‘Women’s Sexual Health Equity’). The process became heavily politicised, with ‘Even the Score’ declaring that, from a feminist perspective, it is unfair that men have several dozen medications to help their sexual problems and women have none.

Dr Leonore Tiefer, associate professor of psychiatry at New York University has been a vocal critic of the medicalisation of women’s sexual concerns for years. I remember her speaking about this very topic at the World Association of Sexology Congress in Montreal in 2005. Dr Tiefer asserts that ‘womens’ sexual issues shouldn’t be treated with a daily dose of medication that changes the chemistry of the brain, but should be prevented through sexual education and relationships that are equal’. I believe that Dr Tiefer’s view is important. Drugs need to be approved on the basis of safety and need and not due to the pressure of public relations activities driven by the very drug companies who are seeking to profit from drug sales.

Flibanserin was developed as an antidepressant but never used for this purpose. It’s action is within the brain upon the neurotransmitters and needs to be taken daily. It can take up to several months before an improvement of sexual desire is noticed – and the improvement has been described as ‘less than one extra satisfying sexual experience per month’. Flibanserin is therefore  NOT a ‘Pink Viagra’. Viagra is a drug that is taken only when a man wants to improve the quality of his erection. A man needs to have a significant desire for sex for Viagra to be able to boost his ‘hydraulics’!

Why was there such a long drawn out process to have this drug approved?

Flibanserin has significant side effects: dizziness, sleepiness, nausea and fatigue. More concerning is the potential for a woman to faint and lose consciousness due to a sudden drop in blood pressure. This can happen when flibanserin is taken with alcohol or with medications that use the same processing pathways in the liver. There is also no data available about possible long term side effects. The FDA has instructed Sprout Pharmaceuticals Inc. to conduct more comprehensive tests on flibanserin (Addyi) as a condition of it’s approval for use in the USA.

Women who have a concern about loss of libido, no desire for sex or a lower sexual desire than their partner need not despair that this medication is not available in Australia. Even if it were available, having done my research, I would be prescribing it in a very limited way. Sexual desire (or ‘libido’) is dependent on many factors. The person needs to address any significant medical conditions, mental health issues and relationship concerns.

At least a quarter of the people who consult me have sexual desire issues. I am well placed with my knowledge and experience to help you and your partner find solutions to these and any other sexual or relationship concerns. Please feel welcome to phone for an appointment with me. It is my pleasure to help couples experience joy and fulfilment in their intimate relationships.

 

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desire concerns, sexual therapy

Dr Tudor is a Fellow of the European Committee of Sexual Medicine

Dr Marie Tudor has attended many sexuality, sex therapy, family therapy and hypnosis trainings over the last 25 years. She …

Testosterone: Men and Ageing

Testosterone is a hormone found in both men and women, although men have much higher levels of testosterone than women. …

sex therapy can aid with mismatched sexual desire or low libido

Libido: Mismatched Sexual Desires

The desire for sex (libido) is complex and influenced by psychological, biological, relationship and cultural factors. To …