Sex drive can completely vanish when hormones are low or out of balance, this isn't uncommon. Most men, not all but most who have low testosterone will have issues with either libido or erection function. Things to consider:

*Total and Free testosterone levels must be checked. Many doctors will only check total testosterone. Total represents all the testosterone in your body. Free represents the useable testosterone in your body, what you actually have access to. Free is the most important number of the two. Both should be measured during any followup blood work when gauging progress.

*LH & FSH levels should both be checked, this will help determine of the low level condition is being caused by a pituitary issue or testicular issue.

*You will want to find a doctor that understands estradiol must also be managed during treatment. There has to be a balance between testosterone and estradiol levels. If estradiol is too high or low, even if you have perfect testosterone levels you'll feel like garbage. When checking estradiol the Sensitive test should be used as it is far more accurate for men.

*You want a doctor that understands testosterone needs to be administered 1-2 times per week in order to maintain stable blood levels. Some doctors only prescribe it once every 2-3 weeks, which will cause a roller coaster in levels. They do this because testosterone, depending on the specific type, normally has a half-life of 10-12 days, but many don't understand this doesn't have anything to do with the functional half-life. Some men do great with a single injection once per week. Others who metabolize the hormone faster need to split their weekly dose into two equal size injections, say once every Monday and Thursday.

*You want to find a doctor that understands the use of an Aromatase Inhibitor such as anastrozole may be needed to keep estradiol under control but also one that doesn't over prescribe it as crushing estradiol can cause the same symptoms of low testosterone, and in some cases even worse. It should be noted, some men need an inhibitor and some don't but you want a doctor that understands the possible need.

*Don't get too caught up into doctor titles. If one is an endocrinologist that doesn't mean they understand testosterone therapy.

*Follow up blood work is very important, normally you'll want to check everything 6-8wks after starting treatment so that things can be adjusted if and where needed. Understand that TRT is a process, things aren't going to get tremendously better fast, but they will gradually improve over time and continue to build and build if the patient remains on his treatment. After the initial followup, blood work should be done around 4 months after that and then normally once every 6 months for as long as the patient is on treatment. If major changes are made to protocol it's normally a good idea to have bloods checked around those times but once every 6 months is a good rule of thumb.

*It's good to find a doctor that understands HCG can be useful in conjunction with testosterone. Many men do much better with this combo. It is not necessary for all men and some men don't benefit from it, but it's something you want to have on the table.

Hope this has been helpful.