Don't blame it all on testosterone

Dear Dr G,

I am 30 years' old and married with two kids.

My wife and I have an active sex life but I have a very active libido and am always seeking something more.

It started with watching porn at work – and was almost caught doing so in a meeting.

This progressed to frequenting massage parlours for "special services" and then to using dating apps which resulted in some unprotected hook-ups.

One day, I had pain from urination and had an unsavoury discharge.

The doctors diagnosed it as chlamydia and treated it with antibiotics.

I told the doctor about my sexual appetite and risky behaviour – he said I was lucky it was treatable with antibiotics and the situation could have been much worse if I had contracted HIV or genital herpes.

I am now quite remorseful and worry I may lose my job and family – what more if I pass on an infection to my completely innocent wife.

Could my behaviour be due to high testosterone levels? Is there a correlation between elevated testosterone and my risk-taking behaviour? Is there any treatment – castration even – or medication that can resolve this?

Testosterone Tom

Risk-taking behaviour can manifest in various aspects of our lives, including recreational activities, career choices and personal relationships.

Testosterone is the hormone that makes men feel youthful, adventurous – and occasionally reckless.

The hormone is found in both sexes and plays a significant role in various bodily functions, including muscle mass, sex drive and even mood.

Testosterone acts on specific brain regions related to reward and motivation.

When testosterone levels increase, these brain regions get activated, resulting in a heightened desire for novelty and excitement, with extra push to seek out thrilling experiences and take risks that we might otherwise shy away from.

But it should be emphasised that the correlation between testosterone and risk-taking behaviour is not absolute.

Factors such as personality, upbringing and culture also play a significant role in how a person evaluates risks and acts on them.

While testosterone may amplify our inclination towards risk-taking, it doesn't necessarily mean that every individual with high testosterone levels will become a daredevil.

Research does suggest that there is indeed such a correlation and individuals with higher levels of testosterone tend to engage in more risky activities, measured with the Iowa Gambling Task.

This includes potentially harmful sexual behaviour, including engaging in unprotected sex or having multiple partners.

Engaging in unprotected sex or having multiple sexual partners without protection exposes individuals to higher risks of contracting infections such as chlamydia, human papillomavirus (HPV), herpes and HIV/AIDS – all of which can cause both short- and long-term effects on physical, emotional, and mental well-being.

It also contributes to the spread of STIs within communities and populations.

Lowering testosterone levels by castration or medicine is not necessarily a long-term solution, it is more crucial to educate individuals against risky sexual behaviour.

Empowering individuals to take responsibility for their sexual health includes promoting safer sex practices, such as consistent and correct condom use, regular STI testing as well as open communication about sexual history and boundaries.

Risk-taking behaviour is a double-edged sword – it can lead to exhilarating experiences and personal growth but can have many negative consequences.

It is important to consider other factors such as personality and upbringing that can shape our individual tendencies towards risk.

So Dr G's response is: "Taking risks can be exciting but always strive for a good dose of prudence and responsibility. So go out there, embrace life's adventures, and keep that testosterone pumping – but don't forget to think with the right head first."