Communication is key for taking on this difficult condition
By Mark Gurarie
Generally unrecognized and often undiagnosed, hypogonadism can significantly impact relationships. Characterized by low levels of sex hormones, especially testosterone, it can arise due to physical injury, congenital defects, cancer or cancer treatmenst, benign tumors, or as a result of other conditions, such as older age, obesity, and metabolic syndrome (a group of conditions that can lead to heart disease, diabetes, and stroke), among others.1
What makes this condition particularly challenging for relationships is the way that hypogonadism impacts intimacy. Among its most prominent symptoms is low libido (sex drive), as well as mood and emotional changes. Men can also experience erectile dysfunction (ED).1 This can lead to severe relationship problems, making it essential that you and your partner are proactive and ready to support each other.
These may not be easy conversations to have, but they’re critical. If you or your partner suffers from hypogonadism, establishing a supportive dialogue is where the road to coping and living well with the condition starts.
The Impact of Hypogonadism
Given the nature of hypogonadism—and the wide range of causes and associated conditions—talking about it means understanding the impact it can have on you or your loved one. In many cases it’s a chronic condition, and ongoing therapy—often taking hormone replacement therapy—is necessary, making management a constant and evolving challenge.
How does hypogonadism affect relationships? Here’s a quick breakdown:2
- Mental health: Studies have found a distinct association between hypogonadism and depression in both men and women of all ages. Rates of anxiety and bipolar disorder are also higher among this population, which can affect relationship quality, sexual satisfaction, and overall quality of life.
- Sexual satisfaction: Given its effects on sexual function and libido, this condition significantly impacts assessments of sexual satisfaction. According to a 2021 study, up to 26% of males and 20%–50% of females with hypogonadism were sexually inactive. Problems with sex are often at the root of relationship issues and they can affect other aspects of mental health, as well.
- Erectile dysfunction (ED): Males with hypogonadism experience a much higher rate of ED, an inability to obtain or maintain an erection. A study of hypogonadotropic hypogonadism, a chronic congenital form of the condition, found that up to 53.2% of males reported this issue. This can further affect relationship health and is associated with higher levels of depression and anxiety and lower quality of life.
Managing and living with hypogonadism is a multifaceted affair. It means recognizing symptoms, it means getting medical help and keeping up with medications and appointments, and it means tending to mental health and relationships. Communication is crucial in all of these areas. Though it isn’t easy, you and your partner will have to have open discussions about this condition and what it’s like to live with it.
Loss of sexual desire is a hallmark of hypogonadism, as is erectile dysfunction, and it can be a chief source of relationship problems. Though it may not be easy to talk about your sex life, it is very important to do so. For both partners, imbalances in sexual desire are associated with less satisfaction in the relationship and higher levels of tension and frustration.3
What are some approaches to broaching this subject? What are strategies you can use to boost communication? Here are some tips:
- Educate yourself: Whether you’re the one with hypogonadism or your partner is, it’s important to learn as much as you can about the condition. Your doctor or healthcare provider can direct you to educational resources, and there are many available online.4
- Kitchen-table conversation: It’s a good idea to broach the topic of sex in a neutral setting. Bringing up sexual problems or dissatisfaction while in bed can cause negative associations with intimacy.5
- Direct communication: In order to promote effective dialogue, use “I” statements, rather than “you” statements when having the discussion. Explaining how you feel—rather than what your partner is or is not doing—and what your aims are is a good starting point.4
- Be open: For both partners, managing low libido means being open-minded, both to each other’s needs and to ways of restoring intimacy. It’s also worth discussing other health factors that may be affecting your relationship and whether to consider therapy or other ways to work on the relationship.5
While talking about how you’re being affected by hypogonadism and airing your feelings may seem intimidating, it’s necessary work. When it comes to issues of intimacy and sex, being open is the best policy. What you don’t want to do is hide your condition from your spouse or partner, as this can only make matters worse.
Ultimately, hypogonadism can be medically managed, and most who get treatment are able to live well with it. Good communication with your partner will prove essential as you take it on, and it can lay the groundwork for an even stronger relationship. The most important thing is to not stay silent.
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