Discouraged with TRT

So Im looking for some advice.

Ive been on TRT for almost a year now (100mg once a week IM) and honestly Im not feeling any better then before test. As of my last labs here is where Im at. I will be starting sub Q at 100mg once a week since my doc is retiring and I havent found a new doc as of yet. The one thing I will say is my libido is thru the roof and it is very frustrating because of my other issues.

Tesosterone---622 ng/dl
Free Tesosterone---2.4 ng/dl (High)
Dihydrotesterone---361.2 pg/mL
SHB---16 nmol/L

I have suffered from ED hence the reason for starting test. I have been on Tadalafil 5mg per day for the last 120 days which seemed to help with the ED but lately it doesnt appear to be helping much. When I do get an erection it seems to take forever to climax (Approx 30 minutes or longer). I sometimes feel this prolonged climax issue could be causing me to loose the erection during intercourse.

So my questions are, could the TRT be causing loss of sensation in my penis causing the prolonged orgasm? Im 56 in decent shape and not ready to stop having sex!

If I was to stop taking TRT what would be the best route in coming off of it? Cold Turkey or reduce injection amounts over time? Im starting to research natural supplements to help with these issues. Any suggestions on what to look at?

Im seriously considering L-Citrulline in addition to the Taladafil to help with the ED in the meantime while deciding on continuing TRT or not.

I would appreciate any ideas, real life experiences, or advice.

Many Thanks, Dave

It seems as though the only protocols you’ve ever been on is once weekly injections, you have to experiment to find out what works, and clearly this protocol isn’t.

Large and frequent injections have been known to put a hamper on sexual parameters, including libido. There is theory for this which is oversaturation of the androgen receptors.

Systemlord,
Thank you for the response.

While I agree with you, it is difficult to change things up alot due to not many docs in my area that deal with this type of thing. Ive looked at Defy and due to cost it is prohibitive.

Since I will be taking over my injections via sub Q do you think I should reduce my doseage?

Quite honestly I may have set my expectations too high when I started all of this. When I started with test my level was 267. Low but not terribly low. When I first started with the shots they were 200mg once every two weeks and that was worse. It was my suggestion to the doc to go to the 100mg once a week. I felt marginally better but not good enough to meet my expectations.

Im so close to just dumping the treatment, let my body normalize and see where im at then.

Gunner@1911 said:

When I started with test my level was 267.

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This is terribly low!

What were your symptoms that you wanted to improve when starting, and what were your expectations?

If your main concern is sensitivity and orgasm then you may want to look into adding HCG to your protocol if you can afford it. It improved my experience on both of those fronts and I’d say that’s the most logical place to start.

Or it could be possible that you need a higher dose(though adding HCG may help with that depending on what type of testicular function you’re able to achieve by incorporating it).

If you plan to discontinue then imho I’d say just drop it cold turkey so that you don’t prolong the process of recovery.

Phil Goodman,

Thank you for the response.

When I started I had minor ED, fatigue, lousy sleep and just general felt like crap. I had heard such wonderful stories of guys on TRT and how they felt so much better. As I have stated that has not been my experience.

I have entertained the use of HCG but quite honestly Im not really interested in more injections. As I stated further back, finding docs in my area is challenging to say the least. My current doc has at least been willing to work with me but she is done July 11th to retirement. The other issue for me is cost. I am self employed without any type of insurance so it becomes a bit of a problem.

Systemlord, My T level at 267 I didnt think was terrible because although low I had been operating fairly normally until the ED started. That is why I figure TRT was the ticket to give me enough of a boost to get to feeling better and hopefully improve my ED.

Gunner@1911 said:

So Im looking for some advice.

Ive been on TRT for almost a year now (100mg once a week IM) and honestly Im not feeling any better then before test. As of my last labs here is where Im at. I will be starting sub Q at 100mg once a week since my doc is retiring and I havent found a new doc as of yet. The one thing I will say is my libido is thru the roof and it is very frustrating because of my other issues.

Tesosterone---622 ng/dl
Free Tesosterone---2.4 ng/dl (High)
Dihydrotesterone---361.2 pg/mL
SHB---16 nmol/L

I have suffered from ED hence the reason for starting test. I have been on Tadalafil 5mg per day for the last 120 days which seemed to help with the ED but lately it doesnt appear to be helping much. When I do get an erection it seems to take forever to climax (Approx 30 minutes or longer). I sometimes feel this prolonged climax issue could be causing me to loose the erection during intercourse.

So my questions are, could the TRT be causing loss of sensation in my penis causing the prolonged orgasm? Im 56 in decent shape and not ready to stop having sex!

If I was to stop taking TRT what would be the best route in coming off of it? Cold Turkey or reduce injection amounts over time? Im starting to research natural supplements to help with these issues. Any suggestions on what to look at?

Im seriously considering L-Citrulline in addition to the Taladafil to help with the ED in the meantime while deciding on continuing TRT or not.

I would appreciate any ideas, real life experiences, or advice.

Many Thanks, Dave

Click to expand...

For some men elevated estradiol causes this issues.

Gunner@1911 said:

Systemlord, My T level at 267 I didnt think was terrible because although low I had been operating fairly normally until the ED started. That is why I figure TRT was the ticket to give me enough of a boost to get to feeling better and hopefully improve my ED.

Click to expand...

A lot of men overshoot the mark for optimal testosterone and end up with excessive levels, even while still in the normal ranges!

Optimal depending on the person varies greatly. My average level is 489 ng/dL on Jatenzo, I get full symptom resolution where many would get sub par results.

You have more variables to consider, injecting a 100 mg dose all at once can be problematic and this has been shown time and time again. More frequent smaller doses may do the trick for you.

Seagal,

At the last labs my estridiol was 34 pg/mL. so it fell in the normal range.

Gunner@1911 said:

Seagal,

At the last labs my estridiol was 34 pg/mL. so it fell in the normal range.

Click to expand...

I would do twice weekly SC 100mg, and wait for few weeks whether there is an improvement.
The estradiol issue is very controversial but I wanted to share this information that for some men even 34 caused issues.
If after few weeks there is no improvement, I would start reducing the dosage.
For unknown reasons, the addition of hcg makes a big difference for some men.



I assume the other symptoms you mentioned resolved, otherwise you could also try increasing the dosage.
Do you take other medications?
At the next blood test I would also look for prolactin, DHEA, pregnenolone, TSH,fT3,fT4,rT3.

Seagal,

When you say 100mg twice weekly do you mean 100mg per day(X2) or 50mg per day(X2) making the total for the week 100?

None of my symptoms have resolved. Still have fatigue, slow muscle regeneration, shrinking testicles, obviously the loss of sensation and ED.

I do not take any meds other than the Tadalafil for the ED. I do take some vitamins everyday. C, Zinc, Garlic, D3

Next blood panel may be awhile due to finding a new doc.

Do you know of anyone who has had success with going the holistic route of treatment?

I can tell you my symptoms greatly improved with more frequent injections, using roughly the same weekly dosage. I went from 100mg once a week to now I spread that over 3 injections.

Also, at our age (I am also 56), you need to laser focus on blood flow issues for the ED. Re-check blood pressure, diabetes markers, inflammation, cholesterol. Do a calcium score if needed. Obviously, diet and exercise are key, but there are many supplements beyond Citrulline that can help boost Nitric Oxide. Tons of threads on these topics. Daily Cialis is also a big help (which you are taking). Don't be afraid to try Viagra or Levitra generics either.

And yes, 267 is low, especially if your Free T is in a similar range. I get complete symptom resolution above 600. I try not to get too high.

Gunner@1911 said:

Seagal,

When you say 100mg twice weekly do you mean 100mg per day(X2) or 50mg per day(X2) making the total for the week 100?

None of my symptoms have resolved. Still have fatigue, slow muscle regeneration, shrinking testicles, obviously the loss of sensation and ED.

I do not take any meds other than the Tadalafil for the ED. I do take some vitamins everyday. C, Zinc, Garlic, D3

Next blood panel may be awhile due to finding a new doc.

Do you know of anyone who has had success with going the holistic route of treatment?

Click to expand...

I meant you should do twice weekly administration to reduce hormone fluctuations with that ester. That's what we probably all agree on.
Next I would increase the dosage because so far there is no improvement. I would use right away 140mg per week in your situation. That's my opinion.
Next I would get a Thyroid hormones, prolactin and DHEA-S blood test asap, because hypothyroidism can cause very similar symptoms as well as high prolactin.

I'm not sure what you mean by holistic approach but instead of testosterone injections, you could have first tried clomifen monotherapy with maybe a micro dose of an aromatization inhibitor (anastrozole).
Holistic would also be to exclude any other possible reasons that cause your symptoms (Thyroid,prolactin).

You could also try Testosterone cream instead of injections. Unfortunately there seems to be no way predict what works best for specific person.

Gunner@1911 said:

Systemlord, My T level at 267 I didnt think was terrible because although low I had been operating fairly normally until the ED started.

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Damage to tissues doesn't happen overnight, spend years at those levels and watch things go downhill!

Golfboy307 said:

I can tell you my symptoms greatly improved with more frequent injections, using roughly the same weekly dosage. I went from 100mg once a week to now I spread that over 3 injections.

Also, at our age (I am also 56), you need to laser focus on blood flow issues for the ED. Re-check blood pressure, diabetes markers, inflammation, cholesterol. Do a calcium score if needed. Obviously, diet and exercise are key, but there are many supplements beyond Citrulline that can help boost Nitric Oxide. Tons of threads on these topics. Daily Cialis is also a big help (which you are taking). Don't be afraid to try Viagra or Levitra generics either.

And yes, 267 is low, especially if your Free T is in a similar range. I get complete symptom resolution above 600. I try not to get too high.

Click to expand...

Golfboy307,

Thank you for the response.

As soon as I start the sub Q injections I will try spreading them out thru the week.

As of my last blood panel everything looked great and within normal limits.
My BP runs normal to just slightly elevated (Pre-Hypertension) on the regular.
My sugar levels are within normal limits
Cholesterol limits are all good which honestly surprised me due to having a family history of high Cholesterol.
I had a calcium scoring test done a month ago and it came back as good as it gets with zero blockage in all of my arteries.
Im in decent shape for my age. 56 5'6" tall 153lbs. I eat fairly well with three meals a day rarely snacking.
I am an occasional smoker about a pack a week. 3 per day on the average. I will drink 2 double bourbons once a week with a meal.
I dont exercise on the regular but my job keeps me on my feet and active. In my spare time I restore cars so that keeps me moving as well.

The reason I went with the daily Tadalafil was so I didnt have to schedule sex with the GF. Im hoping the addition of the Citrulline may give me a slight increase in the ED dept. I just dont want to overdue anything and create a bigger issue.

As I stated before, Im loosing my doc and not sure where I will find another just yet so Im kind of flying blind so to speak so Im just being cautious.

Seagal said:

I meant you should do twice weekly administration to reduce hormone fluctuations with that ester. That's what we probably all agree on.
Next I would increase the dosage because so far there is no improvement. I would use right away 140mg per week in your situation. That's my opinion.
Next I would get a Thyroid hormones, prolactin and DHEA-S blood test asap, because hypothyroidism can cause very similar symptoms as well as high prolactin.

I'm not sure what you mean by holistic approach but instead of testosterone injections, you could have first tried clomifen monotherapy with maybe a micro dose of an aromatization inhibitor (anastrozole).
Holistic would also be to exclude any other possible reasons that cause your symptoms (Thyroid,prolactin).

You could also try Testosterone cream instead of injections. Unfortunately there seems to be no way predict what works best for specific person.

Click to expand...

Seagal,

Until I can get hooked up with another doc getting an order for more bloodwork is going to be tough. I am currently on the search for a doc that will work with me.

What I mean by Holistic is an all natural route as Im trying to get away from the synthetics. Ive been fortunate in my life and not had to ever take any kind of maintenance drugs and quite honestly Im not crazy about taking them to fix this issue either. I just wondered if you had ever heard of anyone using natural supplements to fix this?

I tried the Testosterone liquid(Applied in the armpits) when I first started and had almost zero results from that as well.

Gunner@1911 said:

Seagal,

Until I can get hooked up with another doc getting an order for more bloodwork is going to be tough. I am currently on the search for a doc that will work with me.

What I mean by Holistic is an all natural route as Im trying to get away from the synthetics. Ive been fortunate in my life and not had to ever take any kind of maintenance drugs and quite honestly Im not crazy about taking them to fix this issue either. I just wondered if you had ever heard of anyone using natural supplements to fix this?

I tried the Testosterone liquid(Applied in the armpits) when I first started and had almost zero results from that as well.

Click to expand...

It's too serious to joke about it: maybe it works better with another woman....
I wonder whether just using a bit of Tadalafil along with your pre-TRT hormone level would just be fine for you.
There are many natural supplements that are supposed to increase libido and sexual functioning. I don't know anyone personally that had success with that. I also don't know anyone personally with ED. My testosterone deficiency caused all typical symptoms but ED.

You could try to find a natural healer, why not, I think it's a good idea.

Seagal said:

It's too serious to joke about it: maybe it works better with another woman....
I wonder whether just using a bit of Tadalafil along with your pre-TRT hormone level would just be fine for you.
There are many natural supplements that are supposed to increase libido and sexual functioning. I don't know anyone personally that had success with that. I also don't know anyone personally with ED. My testosterone deficiency caused all typical symptoms but ED.

You could try to find a natural healer, why not, I think it's a good idea.

Click to expand...

As sad as it is to say I have thought about the other woman thing but I really do have a wonderful GF of 13 years and she has been very understanding thru this whole endeavor, so the other woman thing isnt an option.

Yea I have thought about the exact same thing thinking my pre TRT levels and Tadalafil may be enough. That is probably the main reason Im thinking of stopping the TRT and looking for the natural route.

I do actually have a natural healer not too far from me. I might just give that a try too. As I stated before I guess maybe I set my expectations too high for the TRT. I guess maybe I was looking for that fountain of youth solution. No more ED and generally feeling good again.

Getting older sucks but it is better then the alternative!!

Hey Gunner, I'm 68 and new to TRT; I started with gels which didn't absorb - I then started TE injections April 6. Some recent bloodwork showed that my Total T had increased from 320 to around 700 (in the trough). I inject 40mgs every 4th morning, not a big dose.

I write to you because I share the exact same reasons as you for starting T therapy. I haven't felt much positive yet; initially I had more in the way of morning erections, but they seem to have abated the last 10 days or so. Fatigue levels may be a bit improved, but only very marginally. I know I have to be patient.

I notice since starting that I also have less penile sensitivity with the net result being that I seem to work hard at getting an orgasm; it can easily take 20 or more minutes and several times my erection has just called it quits. It calls for more analysis, something you don't get much of here in Canada; they don't want to do the tests you need.

I have spent time on the board here, and I know that getting dialed in is not an easy thing to do, but CAN be done. You have to experiment with things and keep trying. Try to find someone to legally prescribe the T for you, and hopefully give you the test requisitions you need. Then turn to the board here for whatever help you need. That's what I'm doing.

Finally, I appreciate the fact that you'd like to do it "naturally". Looking at my situation (so that I don't comment to closely at yours . . .), at a certain point I don't think it's possible. I developed devastating angina at the age of 41. I tried everything to avoid an operation, to do it naturally. I went vegetarian and lost 100 lbs, 270 to 170. I did that kind of thing for 15 years without much success. Finally I had the bypass, and it was great and is great up to this day 12 years later. Many times we develop issues that nature itself just cannot accommodate and correct. If our vision is bad can we correct it be eating more carrots? Of course not. But thankfully we're lucky to live in this day and age where options exist. We should exploit those options to the fullest; I personally don't think you've done that yet . . . keep experimenting, keep trying.