I’ve been a reader of Low T Wife (now rebranded as High T Marriage) Rebecca Watson for a while now. You’ll see her old brand link on my blogroll to the right (I need to do some spring cleaning and updates, but that’s a story for another day). Rebecca just released her first book, I Want Sex, He Wants Fries: 5-Step Plan to Beat Low Testosterone & Get Your Sex Life Back On Track, and I had a chance to catch up with her.
While the book was written from a wife’s perspective, I think most men who may have issues with low testosterone, or want to know what to keep their eyes on, would benefit from the content within. I find the subject of aging fascinating and have read other books on the subject like Manopause. Changing hormones is a serious thing in both men and women, and impact our lives and health in many ways, including our sex lives. While controlling stress, sleep, diet, and exercise can have a large impact on this, some things are out of our control despite our best efforts. Even if you don’t think this topic applies to you today, I recommend you bookmark this post and revisit it as you get older. I plan to have some baseline bloodwork myself based on this interview.
Hi Rebecca! Thanks for taking some time to help clear the air on the whole low testosterone issue and maybe helping other men and couples as they learn more about this topic. I know it can be intimidating, shameful, and embarrassing for men.
Hi Alex. Thanks for having me.
Most guys like to talk about testosterone and hormones about as much as they like going to Mary Kay parties. Hormones are for old guys and chicks.
But here’s why you should care about testosterone. Quite simply, it’s the hormone that’s responsible for making a man … a man. It’s what imparts energy, strength and stamina to your life.
Testosterone is the red pill of the medical world. On the one hand, there’s this lullaby of soothing voices telling you that testosterone doesn’t matter, that it’s okay if you’re 36 years old and your testosterone levels are 300ng/dL*, that it’s normal for a man’s testosterone to be that low. The general idea seems to be that society would be a lot safer if we could just eliminate those pesky testosterone levels that cause all the problems, and that we’d all be better off if men were more like women.
[*Testosterone is measured in nanograms/deciliters.]
But there are people out there who have discovered the truth. Testosterone does matter. When your T levels are in the 300’s and you feel like crap, and conventional wisdom says that you’re just getting older and a T level of 350 is normal, you need to understand that this is complete nonsense.
What you aren’t being told is that normal isn’t optimal. That’s the red pill truth you need to understand.
The other thing you’re not being told is that low testosterone is quite common; some studies put the number as high as almost a quarter of men over the age of 30 who have clinically low testosterone. In addition, for unknown reasons, T levels have been going down over the last few decades, even after correcting for lifestyle factors like smoking and obesity. In other words, a man today has lower testosterone levels than his grandfather did at the same age, even if they have a similar lifestyle.
When your testosterone levels are low, you lose energy, cognitive ability and focus. You gain weight and lose muscle. You become more moody, irritable, and lethargic. Your sex drive and performance suffer.
What’s more, when your testosterone drops below 300, your risk for cardiovascular disease increases by 200%, you have four times the risk of diabetes and depression, and your chances of getting Alzheimer’s and prostate cancer become significantly higher. Men with low testosterone actually die sooner than men with higher levels!
The reason no one is telling you all this is that most healthcare providers don’t know it themselves. There’s a huge void of information in men’s health issues.
So you may find this all very interesting but you’re only 37. Why should you care?
Here’s the kicker … while testosterone stays level throughout your 20’s and early 30’s, by your mid-30’s, your T levels start to drop by about one percent per year. That’s right. By the mid-30’s, nature starts withdrawing from a man the very hormone responsible for his masculinity.
Most guys will lose at least 10% of their testosterone each decade unless they actively take steps to prevent it.
Here’s the good news, though. In your 30’s and 40’s, you’re at a perfect age to prevent the slow, gradual decline that derails your life. If you’re reading Average Married Dad, you’re striving to excel in all areas of your life … career, marriage, finances, sex life, parenting, and physical fitness. While you can survive with low testosterone levels, you’re not going to thrive.
And thriving is one thing we’re all trying to achieve here. What exactly is low testosterone (or Low T), why does it happen, and how common is it? What are some symptoms to look for?
Here’s a typical testosterone trajectory … In his 20’s, a man has peak testosterone levels and he’s on top of the world! He has energy, focus, ambition, drive. He feels great and all his parts are working. Life is good. And it stays that way for a while.
Then he hits his mid-30’s. [results in declining T levels: ↓T ]. He’s making his way in the world. The career is taking a lot more time and causing a lot more stress. ↓T levels
By now, he’s had a kid or two, ↓T levels … his sex life has dropped off some, ↓T levels … and he argues a lot more with his wife. ↓T levels
He doesn’t have as much time to work out, ↓T levels … he doesn’t get enough sleep ↓T levels … he sits in a cubicle all day, ↓T levels … and his boss is a jackass. ↓T levels
And so it goes. The bottom line is that we’re all living lives for which we’re evolutionarily unsuited. Almost everything about a modern man’s lifestyle decreases his T levels. Yet all of this is going on below the surface, and the guy has no idea. It’s like his car is burning oil and while he can tell that the engine is running rougher than it used to, he doesn’t know the cause.
In the same way, low testosterone creeps up on a man gradually and unannounced. He may realize that he’s feeling more tired than usual and that he’s having a hard time focusing or staying on task, but has no idea why.
He may also notice a loss in muscle mass and increasing ab fat, along with having a tougher time losing weight. As my husband said, “Your arms get smaller and your gut gets bigger.”
Sex drive may become less intense. Paradoxically, a guy whose testosterone levels are dropping will often use more porn because it’s a low-effort source of dopamine. Erections, staying power, and orgasm quality may decline.
Yet another reason to put porn in the box of “not healthy” for most things. I finished reading your book and you really laid it all on the line with your own experience. It was touching and showed how real couples handle what could be a deal breaker if not addressed. Can you give my readers a brief synopsis of your journey with your husband from the exciting start to the troubled times and how you overcame that?
We followed a pretty typical pattern. Great energy and high attraction when we first met. We married and pumped out a bunch of kids. Then came life in suburbia … between the mortgage and soccer games, a stressful job, long hours at work, and less time working out … gradually his energy and sex drive all but vanished.
During the worst of the low T years, that guy I married disappeared. It really did feel like our own personal Invasion of the Body Snatchers. I kept looking for my real husband.
Our journey back was full of mistakes and detours that cost a ton of time and money. We wasted thousands of dollars on things that didn’t work and misinformed professionals who couldn’t help. It was maddening!
The thing that finally saved us was disregarding common wisdom and doing our own research. I spent hour upon hour researching how testosterone affected a man’s life.
The take-away is that you can’t rely on the medical system; you have to be your own advocate. No one will ever care about your health as much as you do, and doctors simply don’t have time to get to the bottom of your health issues during a typical seven-minute appointment. If you don’t know what you’re doing, you’re lost.
I’ve read a number of articles over the year like “Top 10 Ways to Increase Testosterone Naturally.” What has been your experience in using natural means to increase testosterone?
You can definitely increase your testosterone through natural means. The question becomes, “By how much?”
For those guys who have low-hanging fruit … sedentary lifestyle, crappy diet, heavy alcohol use, poor sleep habits, etc. … they can see significant gains from improving their lifestyle. But if your lifestyle is already pretty healthy, there’s not as much room for improvement.
The other consideration is that it takes a lot of energy to make those lifestyle changes, and when your T levels have tanked, quite often you simply don’t have the energy to do what you need to do.
There’s not a one-size-fits-all when it comes to testosterone. Sometimes the winning ticket is a combination of lifestyle changes to boost internal production and supplementing with external testosterone.
Okay, you’ve sold me on testosterone being important, but what do I do with all this information? What’s the best way to optimize my T levels throughout my life?
Well, ideally, you’d run a baseline testosterone level when you’re around 18 or 19 years old and at your physical peak. Then you would check it every 5 years or so to make sure everything is running smoothly.
Of course, in some ways, we’re in the dark ages when it comes to men’s health, so you were never offered that option. If you have sons, this would be a great gift to give them as they turn into men.
However, the most important thing now is just to get a baseline testosterone level so you have something to compare to in future years. You can do a simple blood test for total testosterone fairly cheaply at most walk-in labs without even needing a doctor’s orders.
That’s not something included in the normal bloodwork, and one I’ll probably have them run next time so I can start my own “baseline.”
In I Want Sex, He Wants Fries you talk about your husband’s reluctance to go to the doctor and get checked out. Like most men, I can relate since going to the doctor is about the last place I want to be (just above the dentist). Add to that fact that like nutrition, testosterone knowledge is often a blind spot for doctors. What advice can you give on getting a man to the doctor and what sort of questions does he need to ask to make sure the doctor knows his stuff?
It’s important to understand that unless your doctor has specialized training, he probably has no idea what a healthy testosterone level is and how to achieve it. In fact, after reading this interview, it’s quite possible that you now know more than your doctor does about testosterone.
In I Want Sex, He Wants Fries, I devote a whole chapter to finding a good doctor. To boil it down to essentials though, you need to find someone who has specialized training in testosterone management and regularly treats guys with low T. You really don’t want to be someone’s guinea pig when it comes to something as important as testosterone!
Ha! Probably the first time someone told me I knew more than a doctor. So let’s say the lab results come back as being low and you end up with a prescription. I was aware of the testosterone gel, but didn’t know until I read your book that there were other options available, and that the gel may have issues. Can you talk a little about maybe your favorite prescription options, how expensive they may be, and if those things could be covered by insurance? I’m not expecting you to be an expert in all health plans, but maybe share your experiences you’ve seen in the field with your situation or those of your clients.
Okay, let’s say your total testosterone comes back at 348ng/dL. While that’s clinically ‘normal’, you now know that it’s normal for an 85-year-old man! You try natural ways to raise your level, but nine months later, it’s still not where you want it to be. Now what?
The Big Three of T therapy is gels, pellets and injections. Gels can be expensive, but insurance often covers them. Self-administered injections tend to be dirt-cheap because they’ve been around forever and can’t be patented. Pellets take the least day-to-day effort, but a doctor has to implant them.
I personally have seen the best results with injections or pellets. It seems that most doctors like to start with the gels, but there can be absorption problems. If you try them and they don’t work well, don’t wait too long before you try something else.
Great advice since I bet most of us hadn’t even heard of injections or pellets. Erections are one indication of Low T, maybe sort of a canary in a coal mine sort of way. In many ways the boner pills that you see on TV has less stigma than having Low T. This is something that even MMA guru/comedian/podcaster Joe Rogan talks about (he takes T too and has discussed this social stigma on his podcasts, who would have guessed?). Do you ever run into clients that may be able to medically function and have the occasional sex life that is so important in marriage (be it medically assisted or not), but the rest of their life has red flags about Low T that they continue to ignore?
You’re right, Alex. People associate testosterone with sexual issues, but those aren’t the only, or even the main, red flags for low T. You can have low T levels and see very little change in your sex drive or how your equipment performs.
Instead, what a lot of guys notice first is decreased energy and motivation. Everything just seems to take more effort than it used to. They describe it as being in a fog where they can’t think or remember well. Low-level depression is common; it just depends on the individual.
For those guys who are struggling with erection problems, low T may be the cause. If it is, testosterone therapy will fix it for about 60% of them. For the other 40%, they’ll have to dig a little deeper for solutions.
Maybe the most important part of your book is the relationship stuff. Like a frog that gets boiled, you don’t even realize how shitty things can get over time until it is starting to be too late. And after changes are finally made, and the man is finally feeling more like his old self as opposed to his 90 year old version, things just don’t magically go back to awesome. Talk about what you’ve experienced or seen during this recovery phase and pitfalls to avoid.
This is a critical part of the book. All the testosterone books out there end at the altar, so to speak. That is, they end at the point where the guy restores his T levels. However, you still have a marriage that has sustained gaping wounds and is on life support. What happens after you leave the doctor’s office? How do you restore the marriage?
Low testosterone takes a huge hit on attraction. Women are attracted to bold, confident, decisive men who are fit and muscular and have energy to burn. Low testosterone takes that away from a man. Even after he restores the testosterone, it’s going to take a while to rebuild attraction.
When my husband and I faced this, there were no resources out there to help. I wrote the book I needed back then.
Yeah, recreating that early relationship magic doesn’t happen overnight. I really, really like how you walk people through what to expect as you try to rekindle parts of your relationship that you haven’t shined a light on in a while.
I know your specialty is more in the Low T and men arena, but do you have any insight in how testosterone, estrogen, and progesterone play a role in women’s libido? For example, can this lab work approach you outlined in I Want Sex… be applied by men struggling with this issue with their wives? I think we can recognize sexual attraction in women is more complicated, but I have to imagine that like men, some women’s hormones are out of balance impacting health and sex drive.
Important question, Alex. This interview is getting long, but this question is too central to skim over, so here goes …
Hormones definitely affect female desire; however, it’s a trickier balance. As you know, a woman’s sex drive is normally responsive to a man, rather than spontaneous. It’s tough to know how much of her low sex drive is due to hormones, and how much is simply a lack of attraction.
Sometimes what you find in coaching is that after the husband starts consciously doing the things that build attraction, her sex drive ‘magically’ comes back. Problem solved.
But let’s say there’s something going on with her hormones. What does that look like? As a woman heads into her 40’s, estrogen, progesterone and testosterone all drop, but at different rates, so there’s an imbalance there. Typically, you’ll see a lot of moodiness, weight gain and erratic cycles, her internal thermostat is all whacked out, and she’s going to have a lot of fatigue. She’s likely to have some thyroid issues going on, as well. (Tip: Thyroid is like testosterone in that normal is not optimal.)
If this is your wife, you won’t be able to solve the desire problem until you get her endocrine system functional. However, just like the wife of a low T guy, she may rather jump in front of a moving train than go to the doctor.
Solution? You’ve got to get yourself into a position where you have the leverage you need to get her to the doctor.
So you start doing the things that increase value. You get to the gym, get your career and finances in order, strengthen your leadership, etc. As you do this, it may be that her attraction increases and your problem is solved. If not, well, you now have the leverage you need to get her to a doctor.
Same with hormonal birth control, by the way. If you think it’s affecting her libido, you need to gain the leverage to get her to look at alternate forms of birth control.
This is the The Mindful Attraction Plan in a nutshell. You have to do the work that increases your value in order to have the leverage you need to make the changes you want. It’s the same for men and women. If you’re with a low-drive partner, there are no shortcuts. You can’t talk your way into a good sex life. You have to do the work.
I take that last response as a bonus to my audience, so thanks for at least tipping your toe in on that deep pool. So I know you’re not the only ones who have dealt with this issue, but you’ve taken your experience to another level and are trying to help the masses. What is your Superhero origin story going from regular wife and mom to an expert, author, and coach dealing with helping others with their low testosterone impacts on a regular basis?
There was this interesting intersection where I had literally thousands of hours of research into how hormones affect desire at a time when we started seeing both men and women whose marriages and sex lives were being affected by hormones.
My previous background included training and development at the corporate level, so when Athol approached me about becoming a coach for Mindful Attraction Plan, it was just a matter of adapting my corporate experience to his specific coaching model.
Sort of like the Malcolm Gladwell 10,000 hours thing – you sort of naturally became an expert, and I’m sure working under the Athol model didn’t hurt either. I like that lunch bucket approach and is one that I’ve used too.
Ok, I have to ask: How in the heck did you find time to write a book with five kids in the house? I have two kids and by the end of the day when I should be writing I am hanging by a thread and just want to go to sleep.
Lots and lots of carry-out for the kids. Plus chocolate for me.
More seriously, I had an incredible amount of support at home. My husband very much wanted this book written and encouraged/pushed/prodded/poked me to get it done.
While I had some hesitation about putting our private story out there, he was immediately all in. He liked the idea of bringing something good out of our personal struggle and helping other men avoid the drama he had gone through.
And in the interest of complete disclosure, there were a lot of times I simply bribed myself with peanut M&M’s. You can’t finish a book without copious amounts of chocolate.
That’s pretty great. Pretty hard to do a project like this without support from your spouse. So how do people contact you if they’re interested in your coaching services, and where can we find your book?
Thank you so much Rebecca! Good luck on the launch, and trying to find your own happy bedroom time with that hoard of children you’re rearing!
That’s always the challenge, isn’t it?
Thanks for having me, Alex. It was great to have the opportunity to share something with your readers that is so vital when it comes to men’s health.