Low libido after TRT

Hi guys,


8 weeks ago I came off (self administered) TRT after being on it for 8 months. I decided to do TRT because I am an athlete and I had a severe injury which I was trying to fix.


I have a fairly long history of steroid use (although I swore I would never use again, but the injury I have persuaded me to give it a shot). The reason I did TRT instead of just a small cycle was because my libido has been terrible for years. However when on TRT I found it actually made my libido worse and it did not heal my injury either. So yes I feel foolish.


I ran HCG throughout TRT, and then when I came off I did 5 weeks of clomid and nolva. I dropped the clomid to very low levels because it made me very depressed. Anyway, I finished PCT about 3 weeks ago and I just got some blood work done:


FSH 4.0 (1.5-12.4mIU/mL)
Estradiol(e2) 19.5 (25.8-60.7 pg/mL)
Progesterone 0.61 (0.2-1.4 ng/mL)
Testosterone 6.28 (2.80-8.00 ng/mL)


Needless to say, I was pleasantly suprised to see my test level. But also confused as to why I have low libido. Is it because of my e2 level? Is there anything I can do to fix it?


I would just wait it out, but I have been clean from steroids for 2 years before and still had a low libido, so I don't think time is necessarily going to fix it. When I think about the times I have had high libido, it has usually been on cycle when I start to get itchy nipples - but then I have to take a AI and it crashes again. So to me, it seems like my problem is low estrogen.


I am 28 years old. I know I have made mistakes but I am just trying to fix this. Please help.

There is a thread about low libido here that may help: https://www.excelmale.com/forum/sho...es-not-bring-libido-back-or-it-worsens-on-trt

Its pure speculation without more comprehensive blood work as well. High prolactin, or high SHBG, which makes for a low Free T level, low DHT, adrenal issues or thyroid issues.

ERO said:

There is a thread about low libido here that may help: https://www.excelmale.com/forum/sho...es-not-bring-libido-back-or-it-worsens-on-trt

Its pure speculation without more comprehensive blood work as well. High prolactin, or high SHBG, which makes for a low Free T level, low DHT, adrenal issues or thyroid issues.

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That thread is gold, thank you! Providing me with a lot of areas to research. I'll work my way through it.

I checked the clinic I got my blood test from and they do not check for these other things you mention except thyroid (how likely is it to be that?). And because of where I live (Asia), i'm not sure it will be accessible for me to test these other things, but I will look into it this week.

I can get HCG very easily - is it worth running it again now I am completely off TRT? (I only ran it when I was on test before) with nolva on hand do you think? I do remember getting an increase in libido sometimes for a day or two after using it whilst on TRT.

More labs are critical, as ERO noted. You may not have responded to TRT due to irregular SHBG levels. Your thyroid values are vitally important; if they are off it could explain everything - as could high prolactin. You just don't have enough data to reach a conclusion.

Thanks for all the help. I have found somewhere to test prolactin, SHBG and thyroid. Is there anything else I should ask for?

I think those are all good points. Thyroid though, its not as simple as "TSH" or thyroid stimualting hormone...there's a number of good Thyroid tests. TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies, if you really want to get a deep picture in that area. TSH alone could be a starting point.

My theory for you is Estrogen. I think 19 is too low. I like to look at the ratio of T:E for something in the 14-20 range. You stated yourself that you felt libido but had nipple issues. It's important if you go to an AI as you said, you use very little...no more than .25mg of Anastrozole (if that's your drug of choice). Much more than that and you'll drive E way down. .5mg of that is TOO MUCH at one time. If you go that route, .25mg once a week and see how that goes. Twice per week is an option. I use .15mg per week in a compounded capsule. But I'd keep your regimen steady and treat your Estrogen by letting it rise.

Vince Carter said:

I think those are all good points. Thyroid though, its not as simple as "TSH" or thyroid stimualting hormone...there's a number of good Thyroid tests. TSH, Free T3, Free T4, Reverse T3, and thyroid antibodies, if you really want to get a deep picture in that area. TSH alone could be a starting point.

My theory for you is Estrogen. I think 19 is too low. I like to look at the ratio of T:E for something in the 14-20 range. You stated yourself that you felt libido but had nipple issues. It's important if you go to an AI as you said, you use very little...no more than .25mg of Anastrozole (if that's your drug of choice). Much more than that and you'll drive E way down. .5mg of that is TOO MUCH at one time. If you go that route, .25mg once a week and see how that goes. Twice per week is an option. I use .15mg per week in a compounded capsule. But I'd keep your regimen steady and treat your Estrogen by letting it rise.

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They said they will test TSH,T3,T4,FT3,FT4.

For an AI I was using Arimidex or nolva whenever I got itchy nipples. I used arimidex most of the time because I found nolva gave me a droopy **** almost overnight!

How much of your AI are you using? Too little E2 is as challenging as too much.

CoastWatcher said:

How much of your AI are you using? Too little E2 is as challenging as too much.

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i havent used anything for 3 weeks

"Itchy nipples" typically signifies hormone activity in the blood, not necessarily a sign of elevated estradiol. You may well have pushed your E2 below a healthy range with erratic, heavy-handed dosing.

freddy1234 said:

They said they will test TSH,T3,T4,FT3,FT4.

For an AI I was using Arimidex or nolva whenever I got itchy nipples. I used arimidex most of the time because I found nolva gave me a droopy **** almost overnight!

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Just from what I read others in your situation do, I'm quite certain that you overdosed it. too me, Estrogen management is the toughest part of this, it takes time and small doses to get there. I think that when we say "dialed in" that thats an Estrogen thing for us men. I also think it ideal as no one has docuemented what exactly is too high, that you gauge your body when using Anastrozole (only one I'm familiar with). small small doses.

Get Prolactin tested...very important.

Elevated Prolactin will crush libido.

Vince Carter said:

Just from what I read others in your situation do, I'm quite certain that you overdosed it. too me, Estrogen management is the toughest part of this, it takes time and small doses to get there. I think that when we say "dialed in" that thats an Estrogen thing for us men. I also think it ideal as no one has docuemented what exactly is too high, that you gauge your body when using Anastrozole (only one I'm familiar with). small small doses.

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Thanks Vince, I reduced dosages as much as I could but so that it was still effective whenever I got itchy nipples (typically a day or two after hcg). I did notice my libido didn't drop as much on the lower doses (on the higher doses sometimes I couldn't even get hard).

I have had my blood taken and i'm waiting for results on thyroid, prolactin and SHBG.

If it's just down to my estradiol (which in my very modest opinion I feel like it is) - what is the best way to increase estrogen now that I am off TRT? Is HCG a good idea or not?

I got my further bloodwork:

TSH 1.340 (0.270 - 4.200 uIU/ml)
T3 107.0 (83.0-200.0ng/dL)
T4 8.46 (5.10 - 14.10ug/dL)
FT3 3.20 (2.00 - 4.40 pg/mL)
FT4 1.45 (0.93-1.70ng/dl)
Prolactin 9.51 (4.04-15.20ng/mL)
SHBG 67.44 (14.5-48.4nmol/L)

So my e2 is low and my SHBG is high. From what I have read it seems DHEA might help, and HCG might too. And also Vitamin D supplementation.

It's going to take me a while to get hold of DHEA where I am, so I am going to run HCG. Is there any reason why I should not? Am I doing the right thing?

E2 can take a few weeks to get back up to a normal range after being tanked by too much AI. Its a pain to wait for it, but I have not read of any reliable way to "speed up" the process. Some guys convert HCG to E2 and/or find that HCG helps with libido, but some guys (like me) do not so you will have to experiment to see if HCG helps you in a way that you can feel.

thanks Ero I will give it a shot