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What's up with my testosterone?
Sep 20, 2011

I am 60 years old, and positive for 10 years. CD4 in the 200s, viral load undetectable. My libido is close to zero. Even self-stimulation is not successful. My testosterone tested in the 500's 18 months ago, and sank to 325 6 months ago.

I read both of your books and convinced my doctor to try the injections before the patches. In a test a month ago, my testosterone was at 785, so my doctor was reluctant to prescribe the meds, and I have to agree. Though I have experienced a few instances of "morning wood," my desire is still zilch. My 51 year old partner of 13 years and I have always been extremely sexual, in addition to our great relationship. (OK, crazy horny all of the time.)

Any ideas? My doctor has included the testosterone test in my next quarterly labs. Otherwise, she has no suggestions, though she intimated that I might be obtaining drugs without her consent (understandable).

Thank you

Response from Mr. Vergel

I wish increasing sex drive was as easy as increasing testosterone. But it isn't.

Testosterone is one of the pieces of the puzzle. The other pieces are:

1- How well you are sleeping. Poor sleep decreases erectile function and sex drive. 2- Your blood sugar. People with hyperglycemia may have higher incidence of sexual dysfunction. 3- Weight. High Body Mass Index can impair sexual function. 4- Thyroid function. Low thyroid can affect sexual function. 5- Mental status. Depression and anxiety can block sex drive. 6- Lack of attraction for your sexual partner. Do I need to say more? 7- Being too busy and in "your head". Not making time to relax and be present with your partner can impair intimacy and sex. 8- Alcohol and drugs. Excessive use impairs erectile function and desire.

I am sure I am forgetting a few more.

I am no sex therapist but just a human being like you who enjoys sex and would miss it if I no longer have the drive to seek it. I make sure my hormones are in balance, that I sleep well and enough, that I exercise,and that I make sometime for sex (in this rushed world in which we are all busy and connected through computers and gadgets, free time to enjoy something as great as sex seems to be a luxury for some of us).

We all go through periods when we feel more sexual than other times. And for those of us who have partners that expect a little tender loving care, the challenge is to find non sexual ways to express our love and be intimate without sex when we are not at our best in that department.

Nelson



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