Q. I lost a testicle about 10 years ago, and my remaining testicle is smaller than usual. I had a low sex drive before the procedure, and it is even lower now. Would testosterone therapy help my sex drive?

A. Normally, losing one testicle should not affect a man’s ability to have sex or reproduce. The remaining testicle functions well enough to keep body testosterone levels normal.

However, since you feel your remaining testicle is smaller, that may be a sign it is not functioning properly, for reasons unrelated to the loss of the other testicle. If it is making less testosterone, that may cause decreased libido. Still, without examining you, I cannot be sure your problem is low testosterone. There are many causes of low sex drive, and low testosterone is just one of them.

Your doctor can make the diagnosis of low testosterone based on three separate blood tests, each a week apart. Normal testosterone levels range from 270-1,200mg/dL of blood. If your levels fall below the 270 mark, then testosterone replacement should improve your sex drive.

Unfortunately, testosterone replacement is not easy. You see, testosterone can only be given two ways: by injection every three weeks, or through transdermal patches that are replaced daily. Most men use the transdermal patches. They come in 2-10mg doses; 5mg daily is usually sufficient. Two companies make such patches. The Androderm patch is applied to the scrotum. However, it falls off easily, and when that happens, most of the dose is wasted. The Testoderm patch is best applied to the shoulder area, but it too can sometimes fall off. Also, it may be quite visible to other people around and perhaps embarrassing to some. Nonetheless, the patch systems do work to restore sex drive.

One warning: Some people who think they have low testosterone try to treat themselves with illegal drugs or other substances. This is typically not effective, particularly if the actual cause of the problem has not been determined — and it may be dangerous. To be sure, please see your doctor, get your testosterone tested, and get the proper treatment.

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