Is testosterone safe to boost sex drive?

Q. I love my husband. He is amazing, except for the fact that he hardly ever wants sex. We make love two or three times a month, but only if I initiate it. I fear a year could go by if I didn’t beg him for sex.

We’re in our 30s, so giving up sex seems intolerable. I have suggested he see his doctor to have his testosterone checked, but he is reluctant. He’s read that testosterone could be dangerous for the heart. Is that true?

A. Judging from the hundreds of messages on our website, you are not alone. Many women report that their partners have lost interest in sex.

We don’t know if the loss of libido is due to hormone disruptors in the environment, prescription medications that lower testosterone levels or a relationship problem.

Although the Food and Drug Administration has warned about a possible link between testosterone replacement therapy and heart attacks, new research does not support that connection. A study in the European Heart Journal (online, Aug. 6, 2015) shows that men who were treated with testosterone to normalize their hormone levels actually had 24 percent lower risk of a heart attack.

Your husband should have his hormone levels checked and ask his doctor if there is an explanation for his lack of libido. Counseling also might be helpful.

Q. I am a retired pharmacist, and in the past 20 years I’ve taken five different statins. Each time I started a new one it would be fine initially; then, over time, the muscle pain would slowly start, along with the constipation.

The last one, Crestor, was the worst. I ended up with muscle pain, constipation, neuropathy and memory loss.

I stopped all statins a year ago, and the side effects are now gone. My two older sisters had the same experience, so perhaps there is a genetic link at play.

A. The use of statins in people without heart disease remains controversial. Many cardiologists doubt that drugs like atorvastatin (Lipitor), rosuvastatin (Crestor) and simvastatin (Zocor) cause side effects such as muscle pain, neuropathy and memory loss. That said, we have received thousands of reports from people like you who have suffered similar complications.

There are ways to reduce the risk of heart disease through nondrug approaches. To help you discuss them with your physician, we are sending you our Guide to Cholesterol Control and Heart Health. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. C-8, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

There may be a genetic susceptibility to statin side effects (European Heart Journal, May 1, 2015). That could explain why your family seems to experience them.

Q. My husband and I have used Voltaren Gel for years. It was available almost everywhere in the world except the U.S.

Now it is available OTC in Canada and by prescription in the U.S. I don’t think I would be able to walk if I didn’t put it on my knees twice a day.

A. Voltaren Gel contains diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). This topical formula is about as effective as taking the drug orally. The FDA requires a warning about ulcers, heart attacks and strokes, though a comprehensive review concluded that “adverse effects were usually minimal” (Cochrane Database of Systematic Reviews, June 11, 2015).