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Sexual health is about more than just physical performance. It’s about desire, confidence, emotional connection, and open communication in relationships. After a certain age, many men notice changes in these areas, sometimes subtle, sometimes more noticeable.
While there are many factors that can influence sexual wellness, testosterone may play a central role in helping men maintain both their sexual function and their overall sense of self-assurance.
How Does Testosterone Affect the Body?
Testosterone is the primary male sex hormone, influencing everything from muscle mass to bone density, red blood cell production, mood, and sexual desire. According to a 2022 article published in Reviews in Endocrine and Metabolic Disorders titled “The Role of Testosterone in Male Sexual Function,” adequate testosterone levels are essential for initiating and maintaining sexual interest, supporting erectile function, and sustaining energy for intimacy.
It also interacts with brain pathways linked to reward, motivation, and self-perception. A 2025 article published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging found that testosterone can impact how men process social feedback, influencing confidence and willingness to engage in social and intimate situations.
Therefore, when testosterone levels are optimal, many men may find they have more energy, better mood stability, and an increased drive to connect both physically and emotionally.
What Are Normal Levels of Testosterone?
While “normal” can vary depending on the lab and methodology used, most clinicians consider total testosterone levels between 300–1,000 ng/dL as a general reference range for adult men. Levels tend to peak in the late teens to early 20s, then gradually decline at about 1% per year after age 30–40.
Some men remain symptom-free even as their levels drop, while others experience noticeable changes well before they approach the lower end of the range.
Your doctor or a men’s health clinic can order bloodwork to determine whether your symptoms might be linked to low testosterone. You can also order an At-home Men’s Health Panel here.
These evaluations are important because sexual concerns like erectile dysfunction (ED) or reduced libido may stem from hormonal imbalances, vascular health issues, or a combination of factors.
However, it’s important to note that even if a man’s testosterone levels are technically within the "normal" range, he may still experience symptoms like low libido, fatigue, or mood changes, indicating that his levels may not be sufficient for his personal hormonal needs.
ED in Men: Why It Happens
Erectile dysfunction (ED) in men becomes more common with age. While causes can include heart disease, diabetes, and stress, testosterone levels also play a role. “The Role of Testosterone in Male Sexual Function” shows that low testosterone can contribute to decreased nocturnal erections, reduced sensitivity to sexual stimuli, and lower responsiveness to erectile medications like PDE5 inhibitors.
Men with low testosterone and ED may notice:
- Reduced sexual desire or initiation
- Erections that are softer or harder to maintain
- Fewer spontaneous or morning erections
- Longer recovery time between sexual activity
Addressing testosterone levels can be part of a broader strategy to improve erectile function and satisfaction.
Testosterone, Confidence, and Communication in Relationships
Testosterone’s impact goes beyond desire. The 2025 article mentioned earlier found that testosterone influences how men respond to social cues, shaping their self-esteem in real time. Higher self-confidence often translates to more open and direct communication, which is a crucial element in sexual and romantic relationships.
When testosterone levels drop, some men may feel less assertive or more hesitant in intimate conversations. This can lead to misunderstandings, avoidance of physical intimacy, and even a decline in emotional closeness. Recognizing these changes early can help couples maintain open dialogue and strengthen their connection.
How to Increase Sex Drive and Sexual Wellness After 40
There’s no single fix for low libido, but a comprehensive approach works best. Some strategies include:
- Medical Evaluation: Testing testosterone levels and addressing any deficiencies through lifestyle, targeted therapy, or testosterone replacement therapy (TRT) if appropriate.
- Weight Loss: According to “The Role of Testosterone in Male Sexual Function,” weight reduction is associated with an increase in circulating testosterone levels and an improvement in erectile function.
- Regular Exercise: Resistance exercises can boost testosterone naturally and improve cardiovascular health, which supports erectile function.
- Quit Smoking: According to research, cigarette smoking is a significant contributing factor associated with decreased libido.
When to Consider Testosterone Replacement Therapy
If you’ve been struggling with low energy, persistent ED, reduced desire, or changes in mood, visiting your doctor or a men’s health clinic can help you determine the underlying cause. These providers can:
- Measure your testosterone and related hormones
- Evaluate cardiovascular and metabolic health
- Provide tailored recommendations for improving sexual function
- Discuss safe and evidence-based TRT options if appropriate
In some cases, TRT can help restore sexual interest, improve erectile function, and boost overall well-being. However, therapy should always be guided by clinical evaluation and ongoing monitoring.
The Role of Testosterone Therapy in Sexual Health
In men with confirmed testosterone deficiency, testosterone replacement therapy has been shown to improve sexual desire, erectile function, and satisfaction in many cases.
TRT comes in various forms, including gels, injections, patches, or oral capsules, and should be prescribed only after a thorough evaluation. Regular follow-up is essential to monitor hormone levels, adjust dosage, and track any changes in sexual and overall health.
Building Confidence and Connection
Sexual wellness after 40 is about more than just hormone levels; it’s about maintaining confidence, emotional intimacy, and communication.
Couples who address sexual concerns openly and early may have more satisfying relationships. Whether it’s discussing changes in desire, trying new forms of intimacy, or seeking medical support, these conversations are easier when you feel confident in your body and your abilities.
Sexual health is a vital part of overall well-being. If you’ve noticed changes in your sex drive, erection quality, or self-confidence, talk to a doctor about testosterone testing today.
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