Dale Johnson: This week on the podcast I am delighted to have Dr. Dan Dionne with us. Dan has been a medical doctor with 31 years of experience, particularly in Internal Medicine. So many times, we almost exclusively place issues with hormones in the category of the female gender. But the reality is, all of us as human beings are made by God with hormones and the influence of hormones on our being. That does not excuse us in our responses to God. It does not excuse our sinful behaviors, our sinful emotions, and our sinful actions, but the reality is that males are also influenced by testosterone as well. Dr. Dionne, what are the things that we need to know about the influences of male testosterone as we think through our responsibility as biblical counselors?
Dan Dionne: One of the things that you will see on television a lot are advertisements that ask men if they have low T. A lot of times, men are now thinking about that question and wondering, “Do I feel this way because I have a low testosterone level?” That is not something that men thought about very much in the past, but I get the opportunity to, regularly, when I see my men to ask them how their sexual function is going, how are they feeling, and if I bring it up, they will often say, “Could we check my testosterone levels?” or, “I’m curious if I have problems with my testosterone.” A lot more men are thinking about that or wondering about that.
Dale Johnson: If a man comes in and he’s asking me about some of these issues, and maybe he watched one of those commercials and he’s asking me about low T, as a biblical counselor, I’m going to be somewhat hesitant. I want to talk about the emotions he is having, some of the thoughts that he might be having in the process, but I am going to recommend that he go and see a physician. As you think about low testosterone, what are some of the things that you would recommend to him as a physician as you are giving him advice on how he should handle that?
Dan Dionne: A lot of times the men ask the question, and I am going to ask them some questions to find out if we should be concerned about that. So many men are worried about something called, erectile dysfunction. Many men are worried that they do not have much energy, that they are losing skeletal muscle mass, that they go and work out and they can’t really build much muscle. They wonder if their memory is not working as well because they do not have enough testosterone. Those are things that they will come with questions about. Sometimes it’s other things that are the problem, like they are really not getting good exercise, they don’t have a healthy diet, they’re not getting good sleep, or they have a ton of stress in their life. Their physician can help sort that out, but ultimately, he is going to end up checking their testosterone level to answer that question for them.
Dale Johnson: We’ve discussed this male testosterone issue by describing some of the symptoms that he may be struggling with and some of the ways that we as biblical counselors can recognize these types of issues. But now we come to the issue of, how do we help him? How would a medical doctor give him advice? What things would you recommend as to his options to help him with this problem of low T?
Dan Dionne: First, the doctor will order a testosterone level to be drawn, and it must be done in the morning before 10 a.m. If it’s low once, you have to do it again just to make sure it’s really low. Then if the man says, “I’d like to explore trying testosterone,” then there’s a number of ways to do that. You can do it with creams, patches, or shots, and they all have their pros and cons.
Dale Johnson: That’s the medical side, and a biblical counselor certainly is not to get into the details of providing medical advice. We leave that to the physicians. How does a biblical counsellor think through this process? How can we help a man who is being influenced and impacted by his hormones or by this testosterone?
Dan Dionne: In most cases, the man’s going to have his testosterone checked, and it is going to be normal. Then we’re going to come back to, “Well, what else is going on in your life?” I think that is where the biblical counselor can be helpful. If a man says he is having problems with erections, there are several other things that could be going on. There could be alcohol involved, as alcohol can affect your sexual function. He may just not have a good relationship with his wife, and if they are not close emotionally, then their physical sex life is going to be affected as well. It gets you into the realm of asking lots of other questions such as, “Do you like your wife? Do you find her attractive? Does she like you?” and sometimes you’ll find out some really important things about that man’s heart and what’s going on.
Dale Johnson: That is so insightful as we think about counseling. Oftentimes particularly men are skeptical about coming to us as a counselor. Often what we will see in their marriage is that they have been experiencing these types of problems for a long time, and it finally got bad enough to where they are ready to come and to do whatever to get help. There are going to be a lot of these issues relationally that we can help him work through, where he has seen the impact of these hormones on his relationship. That brings me to another question, as we think about his relationship to his wife, how do we help a wife support her husband through these types of things? It could be she has experienced him being more aggressive, maybe short, somewhat disengaged. She has been impacted by this as well. How do we help a wife support her husband through this?
Dan Dionne: That can be a challenge because most wives do want their husbands to be happy and want to help them to feel well. Most of the time, men are hesitant to do what wives know that their husbands should do. Often, wives need to just wait patiently for their husbands to get a grip, if you know what I mean. Pray and wait. If her husband has gone and asked for help, then there may be some opportunities for her to say, “Okay, how can I be a help?” Sometimes a couple has small children. They are exhausted all the time. They do not get enough alone time in their house to even be intimate. Sometimes a wife might want to help change their schedule so that they are not as tired and they may have to schedule those opportunities together, as opposed to waiting for inspiration or spontaneity, because there may not be as much opportunity for spontaneity. Sometimes wives themselves are having a physical discomfort with intercourse and they might not feel like they want to do that because it hurts. A wife may have an opportunity to go and meet with her doctor and say, “Okay, what can we do about my symptoms so that when my husband wants to be intimate with me, it’s pleasurable for me?” That would be an area that she could explore as well.