Reviving Male Vitality: Addressing Low Testosterone and Sexual Dysfunction

Functional shutdown. Apathy. Weakness. Lack of desire..?

Hello Dr.
Hsu,
For the past two months, it seems like my male sexual function has completely diminished.
I know that my testosterone levels are very low or possibly insufficient.
Is this an age-related issue? I feel somewhat frustrated about it.
What can I do to improve this situation? How can I supplement testosterone? I have seen reports stating that this condition can be addressed by a doctor, but I haven't found a physician who can truly help patients with this issue find relief or improvement.
If possible, I hope you can provide me with concrete and detailed advice on what I should do.
P.S.
I have mild hypertension and am currently on medication (Prazosin 50 mg).
I've heard that this can affect sexual function.
I am physically fit, enjoy exercising, and lead a normal lifestyle without any bad habits—no smoking or drinking.
I feel young at heart and refuse to feel old.
Is there hope for me? I eagerly await your "wise guidance" (i.e., an effective response).
Thank you very much!

Zong Sang, 60~69 year old female. Ask Date: 2013/09/25

Dr. Xu Weikai reply Urology

Hello, generally speaking, the incidence of erectile dysfunction gradually increases in men over the age of 40.
If testosterone levels are low, appropriate supplementation may be beneficial if the deficiency is significant.
Additionally, it is advisable to undergo relevant sexual function tests to check for other factors, such as penile vascular insufficiency, which can potentially be improved with medication.
Medications can affect sexual function, but abruptly discontinuing them poses a higher risk.
Therefore, it is recommended to consult your primary care physician to see if a medication change is necessary.

Exercise should ideally be of appropriate intensity.
Given your age and if there are no other contraindications, you can gradually increase the intensity of your exercise, aiming to maintain a heart rate of above 110 beats per minute for 3-5 minutes.
Of course, it is essential to confirm with your primary care physician whether this is safe.
Sudden increases in exercise intensity may place additional strain on the heart.

Sexual function is influenced by many aspects of physical health, including cardiopulmonary function, liver and kidney function, neurological status, and psychological factors.
If you have further questions or need clarification, feel free to ask for more discussion and research.
Online responses should only serve as a reference; it is necessary to seek medical attention at healthcare facilities when needed.

This message is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2013/09/25

More Info

Low testosterone levels and sexual dysfunction are common concerns among men, especially as they age. Your situation, where you feel a significant decline in male vitality and suspect low testosterone, is not uncommon. Let's delve into the potential causes, implications, and treatment options available to you.

Understanding Low Testosterone
Testosterone is a crucial hormone for male health, influencing not just sexual function but also mood, energy levels, and muscle mass. As men age, testosterone levels naturally decline, typically starting around the age of 30 and continuing gradually. However, various factors can contribute to low testosterone levels, including:
1. Age: As mentioned, testosterone levels decrease with age.

2. Medical Conditions: Conditions such as obesity, diabetes, and hypertension can affect hormone levels.

3. Medications: Certain medications, including those for high blood pressure, can impact testosterone production.

4. Lifestyle Factors: Lack of exercise, poor diet, and high stress can also contribute to low testosterone levels.

Symptoms of Low Testosterone
Symptoms of low testosterone can include:
- Reduced libido (sexual desire)
- Erectile dysfunction
- Fatigue and decreased energy levels
- Mood changes, including depression or irritability
- Loss of muscle mass and strength

Diagnosis
To confirm low testosterone, a healthcare provider will typically conduct a blood test to measure testosterone levels. It's important to have this test done in the morning when testosterone levels are highest. If low levels are confirmed, further evaluations may be necessary to rule out underlying conditions.

Treatment Options
1. Lifestyle Changes:
- Diet: A balanced diet rich in healthy fats, proteins, and carbohydrates can support hormone production. Foods like lean meats, fish, nuts, and whole grains are beneficial.

- Exercise: Regular physical activity, particularly strength training, can help boost testosterone levels.

- Sleep: Ensuring adequate sleep is crucial for hormone regulation.

- Stress Management: Techniques such as mindfulness, meditation, or yoga can help reduce stress, which may positively impact testosterone levels.

2. Medical Treatments:
- Testosterone Replacement Therapy (TRT): If lifestyle changes are insufficient, TRT may be considered. This can be administered via injections, patches, or gels. However, TRT is not suitable for everyone and should be discussed thoroughly with a healthcare provider.

- Addressing Underlying Conditions: Managing conditions like high blood pressure or obesity can also help improve testosterone levels.

Addressing Concerns About Medications
You mentioned taking medication for mild hypertension (脈優50gm). Some blood pressure medications can indeed affect sexual function and testosterone levels. It’s essential to discuss this with your doctor, who may be able to adjust your medication or suggest alternatives that have less impact on your sexual health.

Conclusion
It’s understandable to feel frustrated with the changes in your body and sexual function. The good news is that there are effective strategies and treatments available. Start by consulting with a healthcare provider who specializes in hormonal health. They can provide a comprehensive evaluation and tailor a treatment plan that suits your needs.

In the meantime, focus on maintaining a healthy lifestyle through diet, exercise, and stress management. These changes can have a significant positive impact on your overall health and may help improve your testosterone levels naturally.

Remember, you are not alone in this journey, and with the right support and information, you can regain your vitality and improve your quality of life.

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