In his early forties, William Moore’s daily after-work routine went from bike rides and cooking healthy dinners with his wife, Scarlet, to sitting on the sofa all evening, snacking.
“Want to go on a bike ride?” Scarlet would ask. “Not today.”
“Can you help me with this house project?” “No, sorry.”
“Let’s go run around. The weather is nice.” “No, I’m too tired.”
This cycle went on for months.
Scarlet noticed other changes. William, who never drank coffee, started pouring mugfuls to manage his fatigue. He struggled to get up with the alarm in the morning. Their sex life dwindled.
When Scarlet asked William what was wrong, he brushed off his symptoms, saying he must be “getting sick” or was “fighting something.” Other times, he blamed work stress, but the symptoms continued even as the pressure at work eased off.
Scarlet began to wonder if she was the problem. “Does he no longer find me attractive?” she worried.
Eventually, she put her foot down. She asked him, “Am I not enough?” “Have I gotten stale so fast?”
William listened to his wife, then assured her he was still wild about her. He also admitted that he was feeling different in the bedroom—he had no energy or desire. They decided to get a medical professional’s opinion.
Scarlet made William an appointment at a local wellness clinic, where William asked to have his testosterone tested. In his 30s, he’d taken a test out of curiosity, and his levels had been slightly below optimal. Since he had no symptoms, he didn’t pursue treatment.
Given the symptoms he was having now—the low energy, lack of libido, and feelings of depression—he wondered if his hormone levels had dropped further.
He was right: A blood test showed his levels were around 300 ng/dL, on the low side for a man his age. His estrogen was also high, according to his doctor, who suggested testosterone replacement therapy (TRT).
Editor’s Note:
While 252–916 ng/dL is considered a normal testosterone range for a 40-year-old man, TRT may be recommended to those who experience symptoms of hypogonadism—including fatigue, low energy, and muscle loss (1). High estrogen in men may also contribute to symptoms like erectile dysfunction, low testosterone, infertility, and breast tissue development (2).
An Important Conversation
Despite William’s testosterone levels being clinically low, the couple had some concerns about treatment. Scarlet worried about the risk of prostate cancer and whether TRT could trigger never-before-seen aggression in William. They both previously associated testosterone therapy with ‘roided-out bodybuilders who used unregulated treatment.
William’s physician put their fears to rest, explaining that prescribed TRT is meant to boost men’s testosterone levels into a healthy—not excessive—range. And with regulated treatment, the risk of prostate cancer and aggression is low (3, 4).
Soon after, William started TRT.
Advice for Other Couples
Within two weeks, his energy started to come back. The couple started taking hikes in their free time again—a hobby that they bonded over early in their relationship. Their intimacy quickly recovered, too.
Now around five years into treatment, William, 48, and Scarlet, 39, camp and bike most weekends. William is back to his old active self. Scarlet’s confidence is high.
“I’ve gone from lazy to lively,” William chuckles. “When those numbers come back up, everything gets better in your life.”
They’re inseparable. “I feel like we’re dating again,” Scarlet says, glancing at William. “He gives me his full attention all the time. We’ve been together quite a while, but it doesn’t feel that way.”
Their only regret: not talking about William’s symptoms and seeking treatment sooner.
Scarlet says that once she learned more about low testosterone and its impacts on libido and energy, it lowered the tension in the relationship (5).
“It had nothing to do with me. It was actually the opposite,” she says. “He was not unsatisfied with me, he was trying to satisfy me.”
She urges women experiencing a similar lack of intimate activity to encourage their partners to get their T levels tested, and if their levels are low, support them in treatment.
“If your husband had diabetes, you would want him to get treatment,” she explains. “It’s not the wife’s fault if the husband has diabetes—the same way it’s no one’s fault if a man has low testosterone.”
- Male testosterone: what is normal?
- Different levels of estradiol are correlated with sexual dysfunction in adult men.
- Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism.
- Is testosterone linked to human aggression? A meta-analytic examination of the relationship between baseline, dynamic, and manipulated testosterone on human aggression.
- Testosterone Therapy Improves Erectile Function and Libido in Hypogonadal Men.