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Posted on Wed, 6 Feb 2019
Question: Welcome to 'Ask a Doctor'. Please type your question here...
I am a 67 year old male. I am suffering from erectile dysfunction and low libido. I had my testosterone level checked and was told it was normal. I have normal blood pressure, not diabetic, not a drug user. I basically stopped drinking 4 and a half months ago. Moderate alcohol use before. Not cancer history, no steroid use. Take a statin and cholesterol levels are normal. This has been a problem for at least two years. Very little sexual activity since 2013. It is causing me great concern. What advice can you give me?
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Information

Detailed Answer:
Hello and welcome,

I'm sorry you are having trouble.

There are 2 items that stand out in the history you provided:
1. You are taking a statin - these are now known to diminish both testosterone levels and libido.
2. You had your testosterone level checked and were told it was normal.

So - I am wondering about the testosterone testing that was done. There are 3 tests for testosterone:
1. Total testosterone. Testosterone is transported by a protein in the blood (albumin) to which it may be bound or circulating unbound (free). Total testosterone includes both.T
2. Free Testosterone (in other words, unbound).

While different labs have different standards for normal, here are some general guidelines for men your age:
Total T: 240 to 950 ng/dL for men age 19 years and older
Clinically low total testosterone levels are recognized as less than 220 to 300 ng/dL.
Free T:3.47 to 13.0 ng/dL for ages 65 to 69

I'm providing these numbers just so you have a basis for understanding what was done and can ask your doctor for the numbers if you wish.

As you can see, the range for what is considered normal is very wide. It's possible that your testosterone is lower now, compared to the statin, than it was before. Even though the level falls in the normal range, it's not what your body used to make which is needed for sexual functioning.

I suggest getting your lab results and discussing this with a Urologist.

An erectile dysfunction medication such as Viagra can help with erections, but will not help necessarily with libido, if your testosterone level is lower than what you personally need.

Another thought is to discuss with your primary doctor the need for continued use of the statin because if you have made lifestyle modifications such as decreasing your alcohol intake, it's possible that your cholesterol may be lower without the need for medication for it. Possible - but I don't know your full history of hypercholesterolemia, so that would be something to discuss with your doctor.

I hope this information gives you a place to start.
Feel free to ask further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3137 Questions

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Welcome to 'Ask a Doctor'. Please type your question here...

Brief Answer: Information Detailed Answer: Hello and welcome, I'm sorry you are having trouble. There are 2 items that stand out in the history you provided: 1. You are taking a statin - these are now known to diminish both testosterone levels and libido. 2. You had your testosterone level checked and were told it was normal. So - I am wondering about the testosterone testing that was done. There are 3 tests for testosterone: 1. Total testosterone. Testosterone is transported by a protein in the blood (albumin) to which it may be bound or circulating unbound (free). Total testosterone includes both.T 2. Free Testosterone (in other words, unbound). While different labs have different standards for normal, here are some general guidelines for men your age: Total T: 240 to 950 ng/dL for men age 19 years and older Clinically low total testosterone levels are recognized as less than 220 to 300 ng/dL. Free T:3.47 to 13.0 ng/dL for ages 65 to 69 I'm providing these numbers just so you have a basis for understanding what was done and can ask your doctor for the numbers if you wish. As you can see, the range for what is considered normal is very wide. It's possible that your testosterone is lower now, compared to the statin, than it was before. Even though the level falls in the normal range, it's not what your body used to make which is needed for sexual functioning. I suggest getting your lab results and discussing this with a Urologist. An erectile dysfunction medication such as Viagra can help with erections, but will not help necessarily with libido, if your testosterone level is lower than what you personally need. Another thought is to discuss with your primary doctor the need for continued use of the statin because if you have made lifestyle modifications such as decreasing your alcohol intake, it's possible that your cholesterol may be lower without the need for medication for it. Possible - but I don't know your full history of hypercholesterolemia, so that would be something to discuss with your doctor. I hope this information gives you a place to start. Feel free to ask further.