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the male secondary sex characteristics, the development of facial, body, and pubic hair; deepening of the voice; and muscle development. After puberty, testosterone plays a role in the sex drive. Deficiencies of testosterone may cause a drop in sexual desire, and excessive testosterone may heighten sexual interest in both sexes. In men, too little testosterone may cause difficulty obtaining or maintaining erections. As we age, testosterone levels begin to decrease; as many as five million men suffer from abnormally low testosterone levels (a condition known as hypogonadism).
    Unfortunately, most men never seek treatment either because they just think it is a normal part of aging or they are embarrassed to admit that they have a problem. Very often it is the femalepartner or wife who encourages her husband or boyfriend to seek help. This was the case with William, a fifty-six-year-old male who came to my office on the advice of his wife who had noticed a decrease in his sexual desire and approaches when he was typically a highly sexual partner. He noted that he still liked to cuddle with his wife and loved her dearly, but was rarely having erections upon awakening (a normal event in healthy males) and was not having as many spontaneous erections when feeling aroused. He also described a decreased interest in sex and felt less motivation and interest in other parts of his life as well. Both his blood and saliva tests revealed very low levels of testosterone; prescribing AndroGel (a testosterone gel applied to the shoulders once daily) restored his levels to normal, and his sexual interest and erectile function returned.
    In women during their reproductive years, testosterone surges just before ovulation, in the middle of the menstrual cycle, lead many to a higher level of desire when they are most fertile. Some physicians believe that birth control pills may possibly be the cause of a decreased libido in many women because of how they interfere with ovulation to prevent pregnancy through the manipulation of levels of testosterone and estrogen. Low testosterone levels have also been associated with Alzheimer’s disease and other memory problems, heart disease, and lowered bone density. If you have a low libido and memory problems, it is critical to have your testosterone levels checked.
    Estrogens
    Estrogens are the sex hormones produced primarily by a female’s ovaries that stimulate the growth of a girl’s sex organs, as well as her breasts and pubic hair, known as secondary sex characteristics. Estrogens also regulate the functioning of the menstrual cycle. Estrogens are important in maintaining the condition of the vaginal lining and its elasticity, and in producing vaginal lubrication. They also help preserve the texture and function of a woman’sbreasts. Considering when women with deficient desire are given estrogen and testosterone separately, the increase in desire is not as dramatic as when they are given the two hormones together, estrogen is thought to play a synergistic role with testosterone in increasing lustful desire.
    In women and men, estrogen is also produced in the brain; though the contribution of estrogen to male sexual behavior has not been completely established yet, researchers are speculating that estrogen may also be very important for sexual appetite in men. An unusually high level, however, may reduce sexual interest, cause erectile difficulties, produce some breast enlargement, and result in the loss of body hair in some men. Unfortunately all of us are being exposed daily to a large amount of “xenestrogens,” chemicals in the environment such as pesticides, which look like estrogen and bind to those receptors in the body. Also, inorganic chicken and beef may be injected with multiple hormones including estrogens to plump them up for the slaughterhouse. If you have the choice, it is better to select organic chicken and beef.
    Nitric Oxide
    Nitric oxide is a chemical released by the genitals