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Sexual function and testosterone are key to men’s health

[5 min read] 

In this article:

  • Providence Chief Medical Officer Dan Getz, D.O., encourages men to discuss changes in their bodies as they age. These changes — testosterone levels in particular — impact other areas of your life. Treatments are available, so there’s no need to suffer in silence.

  • Learn more about the changes men see in their sexual health as they age, and how these changes can be addressed by trustworthy providers at Providence who are trained to discuss these sensitive topics.

  • Understand how testosterone levels impact other aspects of men’s health, and what you can do about it — with or without medication.

Sensitive topics for men: Testosterone and sexual health

Sexual health is a defining part of life for many men. But it isn’t easy to talk about the sexual changes we face as we age. At Providence, we realize that discussing these issues is very challenging for patients. Low testosterone and changes in sexual function are real, so our providers create a comfortable place to discuss the various therapies available.

“There is strength in vulnerability,” says Chief Medical Officer Dan Getz, D.O. “Men’s health is about being able and willing to discuss issues. The last thing we want to see is men who delay seeking care — we have to shift that mentality.”

Read on for a question-and-answer session with Dr. Getz to learn why men need to develop a relationship with a provider they trust so they can talk openly and honestly about these sensitive topics.

Q: How important is testosterone?

A: Testosterone is the male defining hormone, and as we age testosterone declines. If you start having symptoms of low testosterone, which can be many, it’s not just related to potential issues with lower libido or decreased erectile function. Low testosterone can cause problems like depression, anxiety, and problems with concentration and sleep.

The symptoms are so wide that we need to screen men if they’re having any related symptoms above a certain age. There are things that we can do and interventions we can perform — not just lifestyle interventions. If those fail, there are medications to improve sexual function, improve testosterone levels and hopefully restore that function back to you and improve relationships with those you love.

Q: What causes low testosterone?

A: Low testosterone is caused by a lot of different things, not just age. Part of a good work up in evaluating a male who has been diagnosed with low testosterone is to look for other causes for low testosterone. Is it hypothyroidism? Is it obstructive sleep apnea that’s untreated?

Low testosterone has become very prevalent in our society for a number of reasons. Some of us have adopted a more sedentary lifestyle. We’re gaining weight. We’re not sleeping as well. Often we’re working very stressful jobs or even working swing shifts. All of these things together influence the body’s ability to produce testosterone.

Q: Is testosterone replacement important for my overall health?

A: Men who experience testosterone deficiency benefit greatly from replacement if they’re candidates. We see a reduction in heart disease and stroke, cholesterol improves, they lose weight, they have better sexual function, and often they’re happier.

Not all men are candidates for testosterone replacement. Discuss it with your primary care provider to identify if you have symptoms related to low testosterone.

Providence is committed to human connection. We’re going to sit with you and explore with you all the different treatment options. Together, we’ll select the therapy that aligns best with your goals and is the easiest for your lifestyle.

Q: Are there ways to increase my testosterone levels without medication?

A: If you’ve been diagnosed with low testosterone, there are lifestyle interventions you can do to increase your natural production of testosterone, such as sleep maintenance. Make sure that you have a set sleep schedule and get appropriate sleep. If you’ve been diagnosed with obstructive sleep apnea, that’s a common cause of low testosterone.

Other things include increasing your fitness level. Resistance training and lifting weights will increase your level of testosterone. A good diet — and making sure you're getting enough healthy fats in your diet — will increase your level of testosterone as well.

Q: Can you dispel some myths about testosterone replacement therapy?

A: There have been concerns that testosterone replacement therapy can cause certain conditions, and we’ve seen a lot of that is not founded in clinical evidence. A good example is the belief that testosterone replacement therapy would cause prostate cancer — we know that’s not true. We know that men with active prostate cancer should not be treated with testosterone. But a man with a healthy prostate is a candidate for testosterone replacement therapy if they’re low, and it does not increase the risk of developing prostate cancer.

Another myth is the risk of heart disease. We know that men who have uncontrolled blood pressure or advanced heart disease should not be treated with testosterone. But if you don’t have those conditions, we know that treating you if you are deficient decreases your risk of developing heart attack and stroke.

Q: How do you measure good sexual health?

A: Optimal sexual health and function is related to having well-managed physical and mental health.

When we talk about penile function, that’s the barometer of men’s health, so if something is compromising erections, we want to do an evaluation to ensure this isn’t a sign of broader health issues. We also want to be able to develop a plan together to help you achieve your goals and regain normal function. At Providence, we want you to feel comfortable having this discussion with us. We’re going to think about all the different therapies that are out there that could improve your symptoms.

Q: Is my sex life connected to my fitness level?

A: Sexual function is closely related to your physical health. If you have higher levels of fitness, if you exercise regularly and maintain your body, you’re going to have better sexual health.

A healthy diet, along with fitness, is critically important to men’s sexual health and function. Foods that are high in fat and salt raise your blood pressure and can potentially compromise blood flow to the penis, which can lead to erectile dysfunction. If men are dealing with excessive stress that’s causing anxiety or depression, that will decrease libido and can lead to erectile dysfunction.

Q: Is it true that pain from a hernia can increase during sex?

A: If you have a large hernia in your groin, it can limit your ability for sexual function because it’s uncomfortable. Men are significantly more prone to hernias than women. And while some men may think it’s a sign of cancer, a hernia is just related to an abnormality either in the abdominal wall or groin area that allows part of an organ to slip through and poke out.

If you notice pain or a bulge, especially with coughing, bending, straining or lifting, you may have a hernia, so please visit your primary care provider. We can take care of hernias with lifestyle intervention, management or surgery to repair it. Work with your physician to find the option that best fits your goals.

The problem with hernias is that they can limit your activities, such as how much you can lift. Be respectful of how much weight you should and shouldn’t lift. Keeping your core strong — engaging your abdominal musculature as part of your exercise routine — will provide a strong band of muscle around those organs to keep them inside. Also the healthier your weight, the more likely you are to protect yourself from hernias.

Q: Why are annual visits to my doctor important?

A: Routine medical screenings are a very important part of sexual health and function. We want to make sure that some of your symptoms aren’t related to diabetes, high blood pressure or even heart disease. Avoid things like nicotine and alcohol, as well as excessive caffeine, as those can compromise sexual function in men as we age.

At Providence, we truly want to partner with you and work together to help you achieve your goals.

Contributing caregiver

Daniel Getz, D.O., is chief medical officer of Providence Sacred Heart Medical Center and Providence Holy Family Hospital.

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If you haven’t seen a doctor in more than a year — or if you have physical or sexual changes that concern you — consider scheduling a wellness visit soon. If you are looking for a primary care provider, you can search for one who’s right for you in our provider directory.

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Related resources

What you should know about men’s sexual health

Low testosterone is the talk of late night. But is it real?

Is testosterone therapy right for you?

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.