Putting Your Heart Into Sexual Health

Your ticker has an important role to play in sexual health

Credit: Christiana Rivers / Unsplash  

Our sex hormones have a lot to do with our sexual health. As we age, these hormones — testosterone for men and estrogen for women — naturally start to decline. Though a decline is normal, it can cause some unfortunate symptoms, like hot flashes and lower overall sex drive. 

For men, testosterone replacement therapy has become fairly common. And though there isn’t a ton of research on the topic (unlike estrogen therapy where there is much more) there is some mixed evidence about hormone therapy’s benefits on the heart. Men need both a healthy heart and healthy levels of testosterone in order to take care of their sexual health — so how can they achieve both? 

Testosterone levels in men tend to decline earlier than estrogen levels do in women. Men start to experience gradually lower testosterone levels as early as their mid-20s, while women experience a more abrupt drop in estrogen in their late 40s and 50s. Testosterone therapy in the US and Canada is generally only approved when a man’s body doesn’t make enough testosterone naturally. This could be the result of a disorder of the testicles, pituitary gland or brain. 

However, a recent study referenced by the Canadian Men’s Health Foundation found that only 6% of men over the age of 65 who were prescribed testosterone replacement therapy had a conclusive diagnosis of low testosterone. This is concerning to some, as there is no consensus around testosterone replacement therapy’s impact on the heart. 

The US Food and Drug Administration (FDA) added warnings to testosterone prescription product labels in 2015 after some studies linked testosterone supplement use with a higher risk of heart attack and stroke. After the updated labels were created, testosterone prescriptions dropped substantially. 

Here in Canada, the British Columbia government’s health authority and online resource HealthLink BC calls for caution about the use of testosterone for several reasons. One, a higher-than-needed dose can cause men’s breasts to become enlarged or sore. It may also cause symptoms of an enlarged prostate, such as trouble urinating. There is also a chance that taking testosterone can lower fertility. 

And while there isn’t any conclusive evidence, experts aren’t sure about taking testosterone’s effects on the risk of prostate cancer. Moreover, like in the United States, the evidence from studies isn’t clear about whether taking testosterone increases (or perhaps even lowers) the risk of heart attack, stroke and blood clots.

Despite all the uncertainty, testosterone replacement therapy can be appropriate and beneficial for some men. What’s abundantly clear is that taking testosterone replacement without a doctor first prescribing it can be very dangerous. There are also alternatives to testosterone therapy if the issue at hand is lower libido or erectile dysfunction. 

If you are experiencing a lower than normal sex drive, erectile difficulties, or other symptoms of low testosterone, consult a doctor to see what options are available to you. If your symptoms are a result of low-testosterone, you may be prescribed testosterone replacement therapy, which, under the right supervision may be safe. 

Taking care of your sexual health involves a multitude of interconnected factors. Whether it’s your heart health, sex hormones, mental health, diet or something else, if you take care of your body, your body will take care of you. And that goes for the bedroom as much as it does for everyday life.