One of the most common questions I get from male patients is, “Do you think testosterone would help my sex drive?” I always answer with one of my typical naturopathic responses, “It depends if your testosterone is low and if that low testosterone is indeed causing your sex drive to diminish.” For the most part, men want simple answers to what we think are simple questions, but the question of testosterone and sex drive appears to be anything but simple.

In about five years of practice I have run hundreds of saliva hormone panels and interpreted hundreds of blood hormone panels for both male and female patients. Roughly 75–80 percent of the time testosterone is in a very good reference range for patients with a low libido. In my opinion, if you only look at testosterone for patients with low libido you are going to have no good answer for the majority of your patients. And, if you give testosterone to men with normal or optimal levels you are likely to cause unwanted side effects and possibly increase the risk of prostate disorders.

When I run a comprehensive saliva hormone profile that looks at cortisol levels, testosterone, androsteindione, progesterone, estradiol, estrone, and DHEA it becomes clear in many cases where the problem is manifesting. The majority of the male patients I have tested have had either very high or very low cortisol levels in conjunction with normal or optimal testosterone.

Low cortisol levels are an indication of adrenal fatigue. When the adrenal glands are in poor condition from years of chronic stress they are unable to provide you with the energy you need for sexual desire. Sex is considered an optional activity and when the adrenals are burnt out, the desire or energy for this activity diminishes.

High cortisol levels are an indication of high current stress load. When the adrenals are cranking out cortisol they are typically doing it at the sacrifice of other hormones, especially the sex hormones. When you are stuck in the fight or flight mode your body is focused on survival, not reproduction.

If you or your loved one is experiencing a decreased sex drive I encourage you to speak with your doctor about thorough testing to determine what exactly is happening. Simply taking testosterone often does not increase libido and if it does there may be some unwanted side effects. In my opinion, it’s best to evaluate the other possible hormonal imbalances and then treat whatever has gone out of balance.