For Me, Postpartum Testosterone Decline Has Been Very Real

unlike most, I have the numbers to justify the feelings

this was, for me, what the youth call a “big yikes”

So we tried to have a baby for three years, sex understandably came to feel like something entirely removed from romance, I jacked off into more cups in more depressing clinic bathrooms than I care to admit, and suddenly, we were pregnant, life got very fast, we lived in the hospital for five weeks thanks to life-threatening complications, and flash forward to today, and I live with an unruly and feral nine-month-old creature that wants everything he lays his eyes on and has fully captured my heart. And, simultaneously, I experienced a common and consequential but almost entirely-undiscussed hormonal change that left me with a profound lack of energy, dampened mood, and compromised libido; only recently have I started to get back to normal. I’m here today to talk about it, for the good of all. Because postpartum testosterone reduction is real and sensitive, and I came into fatherhood with no knowledge of it and no help in dealing with it.

If you’re unaware, yes, it appears that new fathers typically experience significant drops in their testosterone levels after their partners give birth. This is thought to be the product of pretty direct evolutionary forces: with a new baby, a man’s genetic advantage shifts from impregnating as many women as possible to making sure that this newborn survives to adulthood and keeps the genetic line going. This phenomenon is a pretty classic example of a cultural belief that has proved to be empirically verifiable with modern technology; you can find talk of fatherhood depleting male virility in Pliny the Elder, for example, and medieval medical theory often referred to a postpartum loss of vitality in new fathers. Here in the modern era, we can measure the loss of the male sexual hormone, and we find that the reduction is real, appears to have a direct relationship to the amount of childrearing the man is participating in, and can at times be severe.

Of course, for most fathers, this is all confined to the world of feelings and vibes. Most men don’t have any reason to regularly monitor their serum testosterone levels. For me, thanks to a quirk of my medical situation, postpartum testosterone decline wasn’t just a vague set of symptoms but a set of numbers on MyQuest. A lot of guys have felt this reduction in the “manly hormone” without being able to quantify it; I just happen to have been in the unusual position of having the receipts. Two weeks or so before our child was born this past March, my free testosterone measured at 487 ng/dL, which is about average. (But here come the manosphere guys to make fun of me, I’m sure.) Three months after, it was 299 ng/dL, which is still in the normal range as far as the medical establishment goes but low in the overall distribution. That represented a drop of 188 points, roughly a 39% decline. That number has, I’m happy to say, almost (but not quite) rebounded in my latest tests. If you just want the cold math, there it is. But if you want the human story, well, here we go.

Why do I have this level of numerical vigilance at all? Because I have bipolar disorder and I’m medicated for it. Psych meds have a lot of bad side effects, although as I’ve told you (and as the the New York Times refuse to tell you, thanks to their agenda) there’s a lot of good news coming in on that front. Lithium, in particular, is a remarkably important and effective medicine - read Jaime Lowe’s excellent memoir Mental for the best depiction of long-term lithium use as a lived experience - but also has a “narrow therapeutic band,” meaning that the difference between a level that’s too low to be effective and a level that’s too high to be safe is small. So you have to get regular blood tests. In general, psych meds require monitoring of the whole human, to make sure we’re not getting into any dangerous territory. Correspondingly, my psychiatrist runs a regimented battery of bloodwork on me every four months, with tests on my liver function, prolactin, thyroid, metabolic panels, and yes, testosterone. Psychiatrists order those tests not because they’re being nosy about hormone drama but because many psychiatric medications have endocrine and metabolic effects. Antipsychotics and some antidepressants can raise prolactin, which can suppress important hormones and cause sexual side effects; mood stabilizers require monitoring of thyroid and kidney function; metabolic syndrome is a real risk with certain meds, so glucose and lipids get checked; etc.

In short: if you put a cocktail of psychiatric meds in someone’s body, the responsible thing to do is to see what the rest of the body does in response. Relevant to this particular scenario, I always do my tests at the same time in the morning while fasting. My labs have been very steady for a long time, thanks to having had years to get my meds dialed in just right. Still, you have to be vigilant.

In my case, that clinical prudence accidentally made me an unusually numerically-monitored new father. That level of surveillance has its pros and cons. The pro: I know with an embarrassing degree of precision that my testosterone tanked. The con: I know with an embarrassing degree of precision that my testosterone tanked. Which is, like, a big old thing, for men, particularly middle-aged men like me who once took pride in their desirability and associated social signals, even if they’re happily ensconced in monogamy now. And let me be clear that I’m not unaware of the gender dimensions here - almost everything in life is harder for women than it is for men. You can accuse me of virtue signaling if you’d like, but that’s just reality. Shorter lifespan and much higher likelihood of being the victim of (stranger-perpetrated) violent crime and being almost exclusively the sex that dies in war, granted, that stuff’s not great, but it’s just generally easier to be a dude and everyone who’s not a propagandist knows it. Still, there is a certain level of reduction-to-numbers in the male experience that’s quite stark. There is a particular, ah, measurement that you’ll immediately think of, and also there’s testosterone, which in contemporary (read: internet-enabled) culture is the Holy Number for men, the Andrew Tate Constant, the summation of worth. I wish I could say that testosterone doesn’t matter much, but it does both practically and emotionally, and my recent experience with postpartum testosterone decline, the “fatherhood effect,” is that it matters very much indeed.

While the evidentiary record is shorter than many of the known consequences of pregnancy for women, postpartum testosterone decline in fathers is not a vibes-based theory or a pop-psych excuse; it appears well documented and biologically real. But this falls into that large category of things guys aren’t comfortable talking about, and for most men this all happens invisibly, unmeasured and unnamed, which makes it easy to misinterpret as personal failure or emotional withdrawal rather than a predictable physiological response to becoming a parent.

All of this is touchy territory, and for good reason. There’s the whole dad’s ego thing, but there’s also the impact on relationships in a uniquely challenging period of any partnership. New mothers all navigate profound changes to their bodies (weight gain, metabolic shifts, scars, altered breasts, and more) and they naturally deserve reassurance that they’re still desired, still sexy, still fully themselves. Our culture relentlessly desexualizes mothers, and this is a really awful way to reward the people who literally keep our species going. But it’s brutal timing, given the testosterone loss; thanks to these hormonal changes, new fathers are likely in this period to experience a genuine reduction in spontaneous sexual desire, not because of disinterest or diminished love, but because their bodies are quietly hitting the brakes in order to be better at child-rearing. That mismatch can be combustible if it goes unspoken: one partner feeling newly vulnerable and uniquely in need of being desired, the other experiencing an inexplicable decline in horniness he genuinely can’t control. Sorry to go all Dr. Phil on you, but the only real solution is honesty and communication, naming what’s happening without blame, without panic, and without turning a temporary biological shift into a referendum on attraction or commitment.

But to communicate effectively dudes have to admit that this is happening, and many of us don’t want to. Exhaustion, sure, depression (which of course is very common in recent mothers), sure, even a decline in the weight room, these things can be laughed about. “I stopped feeling spontaneously thirsty for sex” is just not something most men are ever going to be comfortable admitting. There’s a particular brand of sheepishness that comes with announcing “I wasn’t horny” as part of a postpartum essay. But, for months, I wasn’t, in a way that was disquieting. It’s less about romantic failure, really, and more about not matching up with a bodily expectation you didn’t realize you had. And it’s awkward to admit because we’re taught to make jokes about the inevitable tiredness, to blame the baby for the absence of sex, and to treat sexual desire as a moral weathervane rather than a biochemical reality we typically don’t control.

Of course, there’s this huge flashing confound that makes it hard to interpret the feelings that attend a drop in testosterone: the lack of sleep. Babies are relentless sleep thieves. And a lot of the effects of lowered testosterone can also be caused by a lack of sleep. You can have perfectly normal hormones and still be so exhausted that you resemble a 14-year-old basset hound in terms of general alertness; you can feel weak and low-energy because you haven’t been sleeping; and yes, you can be too tired to have sex. So when your free testosterone plunges by nearly 40% and you’re also getting up to soothe a screeching, milk-seeking creature at 3:00 AM, the story gets complicated. Did the hormone shift make me less virile? Did lack of sleep make me forever tired? What about the role of the existentially overwhelming challenge of bringing a new thinking conscious moral being into the world, a being that you are completely responsible for, that absolutely will die if you don’t keep it alive, and that you have are uniquely challenged to mold into a good person? Which is to blame? The answer, of course, is all of the above. Biological change and the humbling logistics of parenthood work in concert to make you feel smaller, less ambitious, more omni-exhausted, and yes, less initiative-taking in the sex department.

I will say that the effect can’t all be related to sleep because, I’m very sorry to say, my wife and I are barely sleeping any more today than we were six months ago. I’m still averaging less than five hours a night, and yet as I said, my numbers have risen back towards my baseline.

As I said, nine months after the birth of my bundle of (perfect, beautiful, irrational chaotic) joy, my numbers have largely but not entirely rebounded. As a 44-year-old, I’m afraid that I’m in the part of my life where my T levels will inevitably decline over time, so I’m not too hung up on hitting my exact old averages. And anyway, the numerical rebound itself feels almost silly to celebrate, an incremental biochemical recovery rather than a practical return to normal. But I mention the numbers not to offer a tidy arc so much as to say this is all not permanent nor uniquely catastrophic - now, I’m a little less tired, a little less depressed, and yes, significantly more horny. Hormones change, human beings adapt, and relationships, if we’re honest and sensitive with each other, accommodate the ebb and flow. I’d love it if we had more cultural respect for the impact of this stuff, though, and more general knowledge about the dynamic at all. In reality, we live with the weird bifurcation that postpartum is harder on women - I assure you, this is all harder on women - but also, men have no vocabulary to even talk about it. Women examine because they suffer more, men suffer less but consequently don’t even know how to talk to each other. It’s sad!

I’m sharing this mostly because nobody talks about it. Conversations about postpartum changes in fathers tend toward the sentimental (“I cry when I change a diaper!”) or the jocular (“My wife carried the baby, I paid for the stroller”) or the self-deprecating (“I barely know how to warm a bottle, my wife is the one who actually keeps the baby alive.”) Otherwise, new dads tend to shy away from the thornier stuff, the actual hormonal shifts, the way age and physical fitness intersect with parenthood, the honest embarrassments. I think part of this is a noble impulse not to make postpartum life “about us”; the consequences of having a baby are significantly deeper and more punishing for mothers. But the reticence to talk about postpartum testosterone reduction is also, of course, a vestige of good old-fashioned macho culture, a refusal to let other competing males know that we’re in a less virile state than we once were, a desperate need to feel like we’re still reproductively viable. Evolutionarily, this is understandable. As participants in loving monogamous relationships, it’s just not helpful.

So there it is: 487 ng/dL to 299 ng/dL, a sad state of affairs. (And you’ll note I waited to write this piece until I was mostly back to normal.) I don’t mean to medicalize the whole experience, and I certainly don’t want to sanitize it. Parenting changes you on the smallest and the largest levels, in the worlds of hormones and of emotions, in the grandest terms and in the most deeply banal ways. For me, the testosterone decline was real, measurable, and embarrassing. Nine months in, I’m less squirmy, much more like my old self hormonally while nothing like that old self emotionally or in terms of my most primal priorities - because let me tell you, now I think of nothing but my wife or son - and a little more hopeful that whatever this new version of myself is, it will keep surprising me as I navigate this cliched, wonderful, ancient reality called fatherhood.