My Husband Takes Testosterone and Wants Sex All the Time

Mismatched needs in the bedroom can cause problems in a relationship

Ellen Uzelac,

AARP

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Published April 16, 2026

an illustration shows and older adult couple in the kitchen. The man is at the stove with an overheated pot of tomato sauce. The woman is mixing a salad, staring at the man with a concerned look

Kiersten Essenpreis

Have you ever wanted to have sex but your partner didn’t? OK, folks, raise those hands.

We get a lot of reader emails about desire discrepancy for In the Mood, and no wonder. As sex and relationship coach Stella Harris puts it, “It’s probably the most common issue couples have when it comes to sex. But being a common problem doesn’t mean it has an easy solution.”

This week, an In the Mood reader says their desire discrepancy started when her husband began using hormone therapy. Our experts weigh in.

My husband takes testosterone. This leads to mismatched needs in the bedroom. Can you help? — Submitted via email by M.B.

For couples, the key is recognizing that desire discrepancy is a shared issue rather than one person being “too much” or the other “not enough,” says urologist Dock G. Winston, assistant physician-in-chief at Mid-Atlantic Permanente Medical Group in Washington, D.C.

Winston routinely counsels patients about sex and relationship changes that can occur when testosterone is prescribed. If the change in your husband’s behavior has been “significant,” he says it might be a good idea to review his testosterone dose with his doctor.

About that testosterone. One of the most noticeable effects of a man taking testosterone is an increase in libido, which Winston says sounds like what our questioner is observing.

Specifically, he adds, it can heighten sexual thoughts, interest and frequency of desire.

Typically, Winston says, testosterone is prescribed for men who have clinically low levels of the hormone, called hypogonadism (determined through a blood test), which can show up as a low libido, fatigue, a depressed mood, loss of muscle mass and reduced energy. For the record, however, Winston says desire mismatch can occur with or without testosterone.

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Talk about it. It will likely be a challenging conversation, but certified sex educator Karen Bigman says you and your husband need to unpack this together.

“Tell your partner: ‘We need to find a way for both of us to be happy,’ ” says Bigman, host of the podcast Taboo to Truth: Life & Sex After 50.

Among her recommendations: Reminisce together about when the sex was good and how it felt. Watch a video or listen to a podcast about sex and mismatched desire.

Since testosterone seems to be the factor in play, Harris suggests a conversation opener like: “Gosh, it seems like since you got this prescription, you’ve been more interested in sex than I am.”

She says you each should follow that with whatever “feeling statement” is true for you: “I’m feeling anxious about that” or “I feel like I’m letting you down.”

Revisit your marital agreement. Due to the change in your relationship, certified sex therapist Shadeen Francis says to think about how, if at all, you’d both like to modify your behavior in the bedroom.

“This is less a desire discrepancy problem than a negotiation problem,” Francis notes.

Sometimes, when patients are struggling around sex questions, Francis uses food as a metaphor. For example: “I’m taking a medication that makes me hungrier. Do you need to eat with me every time I’m hungry now?”

Francis says the answer is no — even though the original agreement might have been that the couple shares all meals.

“There is still work to do around this negotiation,” she says. “When you make it about food, it’s less angst-driven and so much easier.”

You should both take time to grieve your loss. It’s not unusual for grief to bubble up as couples reflect on what has changed.

“All changes, even good ones, involve some loss,” Francis says. “Here, the disappointment may be around there being new effort needed to feel connected.”

Talking about your loss, journaling or meditating with your feelings in mind can help you address your grief, says Francis. Practicing gratitude (an appreciation for what you already have) and hopefulness (a positive outlook on what is possible for the future) are also helpful strategies.

Explore new ways to connect. Next time your husband wants to have sex and you don’t, licensed marriage and family therapist Tameca N. Harris-Jackson suggests that you communicate that to him and maybe participate in a different way.

She says to consider saying something like: “I know you’d love for us to be sexual tonight, but I’m not fully in the mood for sex. However, I am open to being close to you or supporting you in other ways. Do you have any ideas?”

Rebuild the romance. Sexologist Sue Milstein recommends building up desire throughout the day by sending sexually suggestive texts to one another and recounting your previous sexual adventures.

“It may help her build up desire, both to send the texts and to receive them from her partner,” says Milstein, cohost of the podcast Unzipping Taboos: Candid Conversations About Sex.

“She may be more likely to want sex later; to want physical contact. If you have all day to think about it, it could definitely be a turn-on. And when your partner starts dating you again, it feels like his desire is being triggered by you, not the testosterone.”

Bottom line: Don’t do anything you don’t want to do. When a partner has an itch, it does not obligate the other person to scratch it.

“Just because he wants it doesn’t mean you have to give it to him. You are not responsible for meeting all your partner’s needs,” says Harris. “That’s like saying, ‘I’m hungry. Make me a sandwich.’ We’ve gotten past that.”

Do you have questions about sex or relationships as a 50-plus adult? Send them to sexafter50@aarp.org.

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