New & Concerned

[concernedgf]

Good Afternoon....
I'm actually writing this because I'm a little concerned about a situation with my boyfriend. Ok A LOT concerned. When we started dating things were great. In a great mood. Did things all of the time. And had a nice sex life. A little while after we started dating he got a new job. His previous job was very physically demanding. His new job is still physically demanding (being on his feet all day) but it is also a lot more mentally demanding. He got his new job in May. Around July/August I started to notice how tired he was. Still wanting to spend time together, but not actually going out to do anything. Then I noticed that instead of sex on a daily or every other day it because once or twice a week. He seemed to get more and more tired and the sex because even less frequent. We made the decision to move in together. He said he was stressed about the move and once we moved in things would be better than ever. Two weeks after we moved in, we had vacation and didn't even have sex on our vacation. He was tired for most of it and really didn't do much. Once we got back the tiredness increased even more. To the point that we basically only go to work then home to the couch. We have now not had sex for over two months. I finally suggested he go to the doctor. She ran a test and at the follow up told him that his testosterone was low. I don't know the exact number but I believe in the 400-500 range. She set up an appointment to go to a urologist. Her exact words were that she would have him better by Christmas and excellent by Valentines. Last Friday he had his appointment with the urologist and his response was to get some over the counter testosterone pills and work out. Needless to say I was really upset by the response. Some background...My bf is 35. 165 pounds. 5'10" tall. 32" waist size. He is athletic and until recently active. He was involved in sports for a long time. He currently works 10-12 days, on his feet for the day and running around. I don't believe in the OTC testosterone pills. #1 it isn't covered by insurance. And they are quite expensive. Not to mention trying to find one that actually works?? The whole exercise thing, I can understand to some degree. However, it isn't like he sits behind a desk and is stationary for 10-12 hours a day. He is active. By the time he gets home some nights he doesn't even have energy to get a shower! Let alone try to work out. And as I said, it has been over two months for any sexual activity. I use to be able to walk by him and get an erection. Now I don't even think he wakes up with one. Or gets one sleeping completely naked with me. I feel like this is putting a huge strain on our relationship and I don't know what to suggest for him to do at this point. Any suggestions? If his regular doctor felt the need for the testosterone meds why did the urologist brush it off?

[Justin]

Sorry for the late reply.

It sounds like he has classic low testosterone symptoms. If he was in the 400-500 range on Total Testosterone, that's below optimal, which is 700-1100. However, in order for a physician to justify treatment he's going to need his Free Testosterone levels checked too. If the doctor you're dealing with hasn't checked these or refuses to, that physician is not suitable for dealing with this issue. Free Testosterone is the most important number, if it's low it does not matter what your Total Testosterone level is. Total Testosterone represents all the testosterone in your body whereas Free represents what's usable. There are many men and I do mean many with OK Total levels but Free levels in the dirt.

Over the counter testosterone supplements, you're right, those are not going to fix the problem.

The Urologist, most urologist and endocrinologist still practice testosterone therapy the same way they did back in the 1970's. For whatever reason, they've chosen not to evolve with the medicine and update and educate themselves on what we now know about testosterone. This isn't to say all urologist and endocrinologist fit this bill but more do than not. Modern testosterone treatment is something a physician has to educate himself on after medical school and if he doesn't, he's going to be in the exact place your boyfriend is in.