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I think it mainly boils down to this: if a man is interested in sex and his sexual function declines to the point that he cannot reliably perform, then he will eventually go to the doctor because he is "not feeling well." The discussion will begin there, and hopefully his testosterone will be tested. At that point he may well have to be his own advocate, depending on the quality of the doctor in relation to HRT. Other than that, there may not be enough motivation to overcome the lack of motivation brought on by low T.