Is Low Testosterone Why I Don’t Want Sex?

Sometimes, and rarely by itself. Low testosterone can flatten desire, but so can poor sleep, chronic stress, thyroid or cardiovascular conditions, medications and depression. Desire sits where hormones, body and nervous system meet. Which means the honest first step isn’t a purchasing some product…. It’s a doctor and a blood panel that actually looks at your hormonal balance within the context of your life habits.  

Let me say that plainly, because the internet will try to sell you something in the next four minutes. If your desire has dropped, the first move is a physician and bloodwork, not a supplement, not a clinic, not a subscription. Low desire is a symptom with a long list of causes, some of them cardiovascular, thyroid, medication related, or about depression. Those need a doctor. In my work as a Certified Somatic Sex Educator and Sexological Bodyworker, I’ve sat with many men who were sure they knew the answer before anyone had looked. I was one of them.

On my podcast I spoke with Dr. Guy Citrin, a naturopathic doctor whose specialties include hormonal health, gut health and regenerative medicine. Everything clinical below is his, attributed to him, offered so you have better questions for your own doctor. None of it is a protocol or mine to prescribe.

Is low testosterone why I don’t want sex?

It can be part of it. Citrin describes andropause in plain physiological terms. It “basically by definition means hypogonadism or ultimately decreased testosterone,” he said. “It just means that the gonadal system is hypoactive, meaning it’s not very strong at the moment, and that you’re producing less testosterone.”

He also named what the marketing leaves out. Asked whether testosterone explains sexual function, he said: “It’s not the only thing.”

Recognizing that testosterone is a real input, but desire isn’t a dial a single hormone turns. It’s built out of hormones, sleep, safety, and how much of your body you can feel. When one of those goes off, the whole system goes quiet.

Citrin described the man who walks into his office this way: “They feel like crap and they’re exhausted and they have no sex drive and they’re anxious.” Low desire is item three on a list of four. It arrives in company, which is why it’s worth testing rather than guessing. He also reports seeing low levels in men well under forty, so if you’ve been told you’re too young for this, that deserves a test.

Is losing desire the same as losing an erection?

No, and conflating the two sends a lot of men down the wrong road.

Citrin drew the line himself. When the conversation turned to erectile function, he set it aside: “That’s actually kind of a little bit of a separate issue.”

Desire is wanting. Erection is response. They travel together often and have different causes. A man can want his partner intensely and still lose his erection the moment he’s in the room with her, because his nervous system has decided this is a performance. I’ve written about that in why do I lose my erection with a partner. 

How do sleep, stress and the nervous system change my hormones?

Citrin works with peptides and expensive regenerative therapies. Asked what matters most, he went plainer: “Limit the amount of toxins you’re getting in and make sure sleep and digestion are on point.” And then: “The fundamentals are the biggest anti-aging tools we have, honestly.” More vividly: “If you have a fire inside that’s burning you up, no matter how many cool stem cells you’re gonna put in, you’re not gonna fix the problem.”

He treats hormones and digestion as one system, too. “I think it’s very important to look at gut health and hormones as a combination,” he said.

I’d add the nervous system itself. A body in sustained threat doesn’t prioritize arousal. It can’t. You can optimize a number and still live in a body that never gets the signal it’s allowed to want anything. So sleep counts, and chronic stress counts, and none of it replaces testing. Testing doesn’t replace any of it either.

Why does testing come before treating?

Because you can’t address what no one has measured, and the standard annual physical may not be looking.

Citrin’s recommendation was modest: “I always recommend a yearly check-in of hormones.” He pointed out that this isn’t routine. “Men don’t check hormones as part of their physical exam,” he said. On the usual panel: “It doesn’t give you an assessment of how you feel. It just tells the doctor, is there an infection or a disease state prevalent.” There are, he said, “so many stages in a person’s life before they become disease ridden.”

He did cite numbers, and I want to hand them over carefully. Citrin said “let’s just say 300 to a thousand is the reference range for total testosterone in the serum or blood,” noting it varies by lab, and that in his clinical opinion men feel best when “they’re gonna look to levels between 700 to a thousand.” That upper figure is his clinical view, not a consensus guideline and not a target to chase on your own. Ranges differ between labs, a single draw is a snapshot, and your number is a conversation with your physician, not an answer by itself.  There are many factors and variables.  The NIH’s MedlinePlus entry on male hypogonadism lays out the recognized causes and symptoms plainly.

Citrin was emphatic about one more thing. Describing men placed on testosterone injections years earlier, he said that once “the body hasn’t been making testosterone in four years, it then shuts down its ability to make testosterone anymore,” and that “many times I cannot get the body to make any more testosterone on its own.” That’s his clinical position, not advice I’d extend. I include it because the sequence matters. Test, understand, then decide with a clinician. Not the reverse.

What if my levels are normal and I still don’t want sex?

Then you’ve learned something real, and you haven’t wasted the test.

A normal panel rules out one explanation and points you toward the others. Sometimes it’s a medication. Sometimes it’s grief, or exhaustion, or a relationship where something unspoken has sat for years. And sometimes desire has gone quiet because the body it lives in has gone numb, which is its own thing with its own history. I’ve written about that in why can’t I feel anything during sex.

What I’d ask you not to do is decide nothing is wrong because nothing showed up. Your experience is data, and a normal lab result doesn’t overrule it. I’ll say this as someone who should have known better: “I’m a somatic sex educator. I wasn’t even aware of Andropause,” is roughly what I told Dr. Guy on the recording. I was certain, I was wrong, and a blood draw is the only reason I found out.

A practice you can try

This isn’t a treatment. It’s a way to arrive at your appointment knowing more than a symptom list. Ten minutes, undisturbed.

1. Sit or lie down. Let your breath go slower than usual, without forcing it.
2. Put one hand on your chest and one on your lower belly. Feel their weight.
3. Ask, in Dr. Guy’s spirit of actually checking: how is this landing in my body right now? Not what you think. What it feels like.
4. Scan for tension without trying to release it. Pelvic floor, jaw, hips, gut. Note what’s gripping.
5. Then ask what I left listeners with at the end of that episode: when you tune into your body, what kinds of support is your body wanting from you? Let the first honest answer come, however unglamorous. Sleep. Rest. Being touched without it going anywhere.
6. Write down what you felt and what it asked for.

Take that page in with you. “My desire has dropped, here’s what my sleep and energy have been doing, and I’d like to know whether a hormone panel belongs in my bloodwork” beats “I think I need testosterone.”

Common questions

1. Is low testosterone why I don’t want sex? It can be one reason, and it’s rarely the only one. Dr. Guy Citrin, a naturopathic doctor specializing in hormonal health, says plainly that testosterone “is not the only thing” shaping sexual function. Sleep, stress, medications, thyroid and cardiovascular conditions and depression can all lower desire, so a physician and a blood panel are how you find out which applies.

2. What should I ask my doctor to test?

Ask whether a hormone panel belongs in your bloodwork, since Citrin notes that men typically don’t get hormones checked in a standard physical exam. What goes on that panel is your physician’s call, so bring specifics about your sleep, energy, mood and desire.

3. Can stress and poor sleep really lower my sex drive?

Asked what matters most for vitality, Citrin said to limit toxic load and “make sure sleep and digestion are on point.” From the somatic side, a nervous system running on vigilance deprioritizes arousal, since arousal is what a body does once it’s safe enough to open.

4. If my testosterone is low, is replacement the obvious fix?

Not according to Citrin, though this is his clinical position rather than universal guidance. He cautions that after years on testosterone injections a body may shut down its own production, and that he often can’t restart it. What’s right for you is yours and a qualified physician’s decision, with testing first.

5. What if my desire dropped but my erections are fine?

Then you’re describing desire, not erectile function and those are separate issues. Wanting and responding have overlapping but genuinely different causes. If the wanting is intact and the body won’t respond, that’s often a nervous system story, not a hormonal one.

Closing

Here’s what I wish someone had said to me years before anyone tested anything. That your desire has gone quiet is not a verdict on who you are, and it’s rarely one simple thing with a purchase attached. It’s a body speaking in the only language it has. Hormones might be part of it. So might exhaustion, or armoring you’ve carried so long it feels like your personality. You get to find out.

If you want a place to begin, the Genital Awakening Meditation is free, and comes with a 12-point genital armor checklist so you can see what your own body is carrying.

And if you’ve had the bloodwork done and the wanting still hasn’t come back, Reclaiming Your Pleasure is where that work goes deeper.

Rahi Chun is a Certified Somatic Sex Educator and Sexological Bodyworker, and the creator of Somatic Sexual Wholeness. This piece draws on his conversation with Dr. Guy Citrin, a naturopathic doctor specializing in hormonal health, gut health and regenerative medicine, on the podcast Your Body Remembers Pleasure. Dr. Citrin practices at Citrin Wellness. Nothing here is medical advice. Please see your own physician. Related reading: why do I lose my erection with a partner and why does sex feel like a performance.