12/20/2025
Low libido doesn’t automatically mean you need testosterone.
I know that’s not the narrative right now, but it’s more nuanced than that.
This patient came to me with low testosterone, vaginal dryness, pain with seggs, and very low desire. Instead of jumping straight to testosterone, we started by addressing estrogen and progesterone decline first: v*ginal estrogen cream, an estrogen patch, nightly progesterone, and added vi****ory therapy to reintroduce pleasure without pain.
Four months later and her libido improved significantly!
Could we still add testosterone? Absolutely. But this case is a good reminder that libido isn’t just about a dosage, it’s about comfort, arousal, safety, and pleasure. Your brain is your most important sexual organ!
A lot can come from (and you can too😉) removing pain, supporting tissues, improving sleep and mood, and helping the nervous system feel safe again.
Testosterone can be an amazing tool, but it’s not the only one in the toolbox.
Have you ever been told testosterone was the only option for low libido?