Home / Low libido
Low libido
A libido you do not recognize deserves a real answer
A change in desire is not something to just live with, and it is not something a single hormone test can explain either. The Choosi Read looks at total and free testosterone, the protein that binds most of it, and estradiol, all read against your history by board-certified OB/GYN Dr. Tiffany Hall.
Not something to just live with
It might be more than stress. It is worth finding out.
Something shifted, and no one told you why. Interest faded, arousal feels different than it used to, or connection with a partner sits behind a wall you did not put there on purpose. You have probably wondered whether it is stress, your relationship, a season of life, or simply what happens after 40.
It might be one of those. It might also be your hormones, and that is not something you can figure out by thinking about it harder. If a doctor has already told you your labs are normal, that answer was likely true and also incomplete: a standard panel usually checks one hormone, if it checks any, and rarely looks at how much of it your body can actually use.
What we actually run
The markers that explain it
Libido has more inputs than any single test can capture. One part of it, the hormone part, is something we can read directly: how much testosterone your body has, how much of it is actually free to act on tissue, and where estrogen sits. Here is what we run and why.
Sex hormones and binding
| Marker | Why we run it |
|---|---|
| Total testosterone (ng/dL) | Read for libido, energy, and lean body mass context. |
| Free testosterone (pg/mL) | The bioavailable fraction. Total can mislead alone. |
| Sex hormone binding globulin (nmol/L) | Sets how much of your testosterone is actually free. |
| Estradiol (pg/mL) | Primary estrogen, read against cycle day when relevant. |
Why one number is not enough
Total vs free: why the binding picture matters
Two women can post the same total testosterone result and feel entirely different, because a total number does not say how much of it your body can actually use.
Sex hormone binding globulin, SHBG, is the protein that carries testosterone through your bloodstream. Testosterone attached to SHBG is not available to tissue. Only the small unbound fraction, free testosterone, is what your body has on hand to work with. When SHBG runs high, a total testosterone result that reads in range can sit next to very little free testosterone.
This is one reason a panel that only orders total testosterone, when it orders testosterone at all, can call your labs normal while your experience says something else. We read total testosterone, free testosterone, and SHBG together, alongside estradiol and the rest of your panel, so the number on the page and the way you feel get reconciled instead of argued over.
Libido is not explained by hormones alone. Sleep, stress, relationship context, mood, and certain medications all play a role, and The Read is not built to sort those out for you. What it does give Dr. Hall is the hormone piece of the picture, clearly, so it can be weighed alongside everything else instead of guessed at.
After your results are in
What happens after the Read
Dr. Hall reviews your total and free testosterone, your SHBG, and your estradiol against the rest of your panel and your history. If the hormone picture points toward treatment, she will walk you through what that looks like, pellet or cream, and build a starting plan from your numbers instead of a standard dose. That conversation continues on the Hormone Therapy page.
If your panel points somewhere else first, thyroid, iron, or sleep, the plan follows what the data shows rather than the symptom alone. Either way, nothing is prescribed off a single complaint. The Read comes first, every time.
Next step
Begin with The Read.
A change in libido deserves a real look, not a guess. Book The Read and Dr. Hall will tell you what your hormones are actually doing.