Let’s take an adult male with good testosterone of 600+ ng/dl and lower it with an anti-androgen. A big percentage of men will start to feel the drop in their testosterone when they hit the 400’s. As they hit the 300’s, anxiety, mild depression and brain fog will probably start to set in. They’ll notice their libido is down significantly and perhaps experience the beginnings of erectile dysfunction. Morning erections will become less hard and more infrequent, often leading to venous leakage. They may also suffer from anemia, fatigue and disturbed sleep. Often their working and verbal memory will suffer and they will notice performance decreasing at wok. Some of the men will have low estradiol and their joints will hurt and have night sweats.
So, tell me how a guy is supposed to maintain his marriage with all of that going on! Sure, the wife may stay with him if she’s a Gandhi sort of woman. But many won’t. Furthermore, many women do not understand that it is hormonal. They take it personally and assume the lack of interest is because of them.
This is why the typical response of endocrinologists to not treat low testosterone is so cruel. Besides the fact that low testosterone increases the risk for many nasty medical conditions such as diabetes and hardening of the arteries, the subject of my book Low Testosterone by the Numbers, low testosterone also will rip apart or at least jeopardize many committed relationships and marriages. Making matters worse are the unbelievably toxic responses that many endos tell their low T patients. In other page, I will relay some of the stories where endos told men suffering with very low testosterone to just use sex toys or go to a sex therapist or “get some counselling!”.”
And it’s not always endos: our society has a very strong bias against testosterone, not realizing that testosterone is part of the glue that holds relationships together in men that want to be committed. Now I admit that higher testosterone men have been shown in some studies to be less faithful. However, my point is this: a big percentage of men do not want that and want to make their marriages and relationships work in the long term and low testosterone can rip all of that apart. So, yes, testosterone could be a tool to be used for the singles, multiple partner lifestyle. But it can just as easily be used as a tool to greatly improve and maintain a committed relationship.
And one of our senior poster made some fantastic points that underscore this after being greatly helped himself by HRT:
“If this was a women’s health issue there would be a national organization fundraising for a cure and awareness campaign. I agree with this 100%! It’s sad, I think a lot of midlife crises and ruined marriages are a result of low T. I think a lot of “depression” is really low T and the pills obfuscate the problem resulting in all sorts of issues and early death. This is why I’m happy to share of my story with just about anyone that will listen – if I can help one guy recognize the signs early enough and seek help, that’s a huge win. If someone had educated me, the last 5 years of my life would have been very different…” 
As I have pointed out in other pages: study after study has shown that the lower testosterone males are ones that are more aggressive and more likely to fight. Why? They feel more anxious and more on edge.
NOTE: Statistically you may know that marriage lowers testosterone. Of course, if your ultimate goal is to maximize testosterone, then a guy would conclude that marriage is not a desireable solution. However, most men feel that taking a slightly lower testosterone level is worth the
1. Women Assume Erectile Dysfunction is Due to Boredom With Them. If a guy can’t get an erection, the women immediately assumes, “It’s me!” Of course, the poor guy just needs some sympathy, but instead finds that he’s deeply hurt his wife or partner’s feelings. It’s can create a vicious circle and is something that really requires a lot of communication. However, many men are weak (or embarrassed) about discussing the subject, and the woman walks away thinking her man is just not interested any more. Check out this post as an example:
“When signs of ED during relations showed up, she thought it was her, I thought it was me until I went and got bloodwork. Now with it being addressed, all is well thus.”
CAUTION: HRT is not for everyone. There are some patients with clotting disorders, kidney issues, hypertension and certain other medical conditions where it may not be appropriate. Discuss with your physician.
2. Women Take Low Libido Personally. One of our senior posters noted that that his close friends broke apart due to the man’s complete lack of interest. Again, a guy who has a low libido due to low testosterone will very likely be apathetic, anxious, depressed and about as romantic as a rock. How long can one’s partner handle that?
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“Our good friends are going to split and it is my guess that the underlying cause is due to low T. The husband went to my doc and was given Axiron and has not used it. They are just so far gone that it is too late for them. The wife is miserable after many years and wants a shot at happiness. The husband seems very foggy all the time. They have not had a sex life for many years. It’s just a mess. Very unfortunate…I had a confidential conversation with him last year and found out that he has basically no sex drive. I told him about my experiences and how the pellets really turned things around for me.He did see my doc, but I didn’t want to be overly nosy, etc. He never brought it up again. His wife told my wife that things are bad and that he didn’t apply the Axiron, etc. She is just done. Think it’s too late for them.” 
3. Low T Impacts The Mental and Emotional. Just to drive the point home, one man wrote in who had not developed erectile dysfunction yet from the low testosterone. However, Testosterone Really Impacts the Brain and this guy said this is what tore apart his marriage of 14 years:
“I’ve had low T for about 8-10 yrs that I know of. I guess I put my head in the sand about my condition trying only the gel treatment only for a short amount of time. So lets say I have not done anything since that but maybe take a few supplements here and there. I’m at the point in my life that my wife of 14 yrs wants to call it quits in our marriage. I have all the emotional traits that come with having this except ED. Need help.” 
4. Guess What? Sex Is Important To Women Too! A number of men have commented that the improved sex life has greatly helped their marriage. There are many reasons for this, but one of the big ones is that the oxytocin released post-orgasm increases bonding. This is very important for men and critical for women. And women need the increases in dopamine and other post-orgasm neurotransmitters just like guys do. Consider what this man wrote:
“As many of you who regularly read this forum know, I’m a proponent of testosterone supplemention via Testopel pellets. I have progressed over a two year period from barely being a sexual entity to now having sex as a regular/frequent mainstay in my life. My marriage has benefitted from our newly found intimacy (though not so new any more – meaning it is still great but isn’t new anymore) and things are just going well…Even though we are a bit older I got a vasectomy over a year ago as she is not through her changes yet so this combined with the Testopel has made sex unbelievable.” 
5) It Helps You Look Better. Only guys care about appearance, right? Wrong! Women are very powerfully attracted to a good physique and a poor physique will turn them off as I document in my link on The Female Libido and Looks. And respectable testosterone levels can make a significant difference with both one’s workouts and weight loss program. For example, if you are low T, you just don’t feel like going to the gym. You’re often tired, anxious and slow to recover. In addition, many studies show that HRT will lead to modest weight loss. No, it’s not a panacea, but it helps. And, yes, testosterone activates the mTOR pathway which accelerates muscle gains. Look at what this man wrote about “letting himself go” in these categories:
“My wife of 13 years was cultivating friendships online and was planning encounters of the sexual kind including some old sex partners. When I found out it kind of jolted me. I really took a look at who I WAS. I am a great guy but I was letting myself go physically and dropping the intimacy. We were like roommates. I think she was going through some hard times also of just not feeling for sex. But those feelings of not wanting sex were just plain boredom of me and eventually she made that realization. That’s when she started with the conversations. I said to myself OK I can’t stop feelings that my woman has for someone else but I can make MYSELF the best I can be. So I started exercising and eating right and reading about Peak T after getting a low reading. She has decided she likes what she sees and does not want to throw it away. I have been doing my part in the bedroom and making it real interesting. I have lost about 45 lbs and still on my quest to lose more.”