I was diagnosed with very low T (below 250)several years ago and Testosterone therapy made a HUGE improvement in my quality of life. My concern is, if for some reason I had to stop taking Testosterone (i.e., a cancer diagnosis, or inability to afford it if I lost my insurance coverage) would I become impotent? I assume that since my T level was originally low, and since beginning treatment my testes have not had to work, they may no longer be able to produce any T at all. My natural level right now may possibly be zero. (I make the distinction here between infertility and impotence – at my age I am no longer interested in having children, but I AM worried about the prospect of becoming sexually non-functional).
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I’m glad that testosterone therapy has improved your quality of life. I hope you understand that testosterone replacement therapy (TRT) is controversial and that many questions remain about its effectiveness and especially about its possible side effects.
If you were to stop taking it, there is a possibility of sexual impairment. But this effect—and risk of all withdrawal effects—depend on many factors:
• Duration. The longer you take TRT, the longer it takes the body to readjust to making its own testosterone. Risk of adverse withdrawal effects increase with duration of use.
• Dose. As the dose increases, so does the risk of adverse withdrawal effects when you stop.
• Tapering off or cold turkey? Tapering causes fewer side effects than suddenly stopping.
• Individual factors. All things being equal, some men develop more withdrawal effects than others.
Possible withdrawal effects include—in alphabetical order, not with most likely effects first: anxiety, depression, fatigue, headaches, mood swings, muscle tissue loss, low libido, sexual dysfunction, weight changes.
I’m not a doctor, let alone an endocrinologist. For a better idea how you personally might react to ceasing T, I urge you to consult with the prescribing physician and then get a few other opinions as well. Testosterone replacement is complex. To get a realistic idea of what might happen to you, talk to some experts.