Back by popular demand: author Nelson Vergel wrote Testosterone: A Man’s Guide in part to respond to men’s queries about their diminishing sex drives.
Speaker, survivor, and author Nelson Vergel gives OutSmart the no-longer-skinny on ‘Testosterone: A Man’s Guide,’ his first book in over a decade
by Steven Foster
Steven Foster: It’s been 11 years since your first book Built to Survive hit the shelves and became an almost de facto manual for living with HIV. Why this book for your follow-up?Nelson Vergel: After my first book, I began to get a lot of e-mails from men—healthy men, not just men with HIV—who wanted to know if they needed to have HIV to get some help with hormone therapy. And that really struck me that we needed to begin providing this information.
The book is incredibly comprehensive.
It is time to package all of this information. But the information in here is practical—it’s not a textbook. This book basically has all the facts on how to manage side effects and maximize benefits, choose the right options, know if testosterone is for you. Not everyone should be using testosterone.
What made these men write?
The first thing people notice is not being very interested in sex. But it goes beyond that. You’re not connecting, you’re kind of lackadaisical about life. You’re not really depressed, but you’re in a funk. You don’t go out like you used to, you don’t enjoy hobbies like you used to. There’s no zest for life. The mood, the connection, the way you relate to others, the way you deal with stress.
But doesn’t a loss of sexual drive occur naturally with age?
As we age, testosterone goes down. Illnesses make testosterone go down. Sometimes there’s not a real reason why. I’m not saying that low testosterone is the only reason people have those symptoms. We all go through ups and downs. But if it’s a trend downward and you’re not that old, then it’s a good thing to go to your doctor and have your testosterone checked.
It seems like there’s such a stigma about that—men and low testosterone.
The first step is to recognize you have a problem, and that’s very difficult for men. To admit they’re not at their best, that sexually they’re not interested in performing? Those subjects are moot to most men.
Do most doctors just say, “Oh, here’s some Viagra”?
Yes, a lot of doctors do that. Viagra is so easily prescribed. And people can find it online from other countries without a prescription. But it’s not the solution to the problem—it’s just a Band-Aid, using Viagra. And studies have shown that people with low testosterone respond very well to Viagra. But it doesn’t work as well or as long. And your drive and your hunger for sex is not enhanced by Viagra. With Viagra you need stimulation. You actually have to be driven to have the sex. Testosterone lights that fire. Viagra might just provide oxygen to that fire.
What has testosterone replacement therapy [TRT] done for you?
Saved my life. I’ve been HIV-positive for 27 years. In 1993 I was losing a lot of weight through the wasting syndrome before the protease inhibitors arrived. I was in Los Angeles and guys were using testosterone underground and they looked great. They had HIV like me, but they looked great. But I was all, I’m not gonna get on that, it’s gonna kill my liver and my immune system.
TRT had bad press?It still does. But I’d lost 30 pounds already and I needed to do something because back then we didn’t have any meds. If I hadn’t gone to testosterone I would not have survived to ’96 or ’97 when the protease inhibitors came in and saved some of us. But a lot of my friends didn’t make it.
What about the current view?
Testosterone is not the answer to everything. It can create problems if you don’t know what you’re doing. But it’s like anything in life. If you’re taking a medication, you need to know what you’re doing. I’m very confident that anyone who has any questions about testosterone can find the answers in this book.