Lack of Penis Sensitivity

Thread starter #1
Hey Guys,

I'm having issues with penis sensitivity.

Long story short, I started TRT in August 2018 after being diagnosed with Low T (Test in Aug showed T @ 187ng/dl and Free T @ 3ng/dl). Since starting the treatment I have had great results in terms of the way I feel, weight loss and getting back into shape. The thing is I also split up with my wife early last year so other than masturbating I didn't really get the enjoy the benefits in terms of libido and erections until I started dating again around November. This is when I realised that I cant reach a climax during sex with a condom on and also really struggle without a condom. My erections are good (But not as good as when I first started TRT) to start with but they seem to soften after some time. I'm thinking this is due to the lack of sensitivity also. I don't have any issues getting to a climax masturbating. Libido wise I'd say I have a pretty decent sex drive.

I've been reading as much as I can on here and there is reference to E2 levels playing a role and also HCG helping with sensitivity but I have been since on HCG since I started TRT.

My current Protocol is:
60mg Test every 3.5 days
750iu HCG every 3.5 days (combined with Test shot)
45mg Armour thyroid per day
5mg Tadalafil per day
1500mg Metformin per day

My latest labs are:
Total T: 1154ng/Dl
Free T: 28ng/dl
E2: 45.21pg/ml
SHBG: 40nmol/L
FT3: 4.66pg/mL (Note: Armour thyroid dose at time of test was 60mg/day and is now reduced to 45mg/day)
FT4: 9.2442pg/mL

I've spoken to my Dr about it and he has recommended an AI to bring down my E2. There seems to be a lot of contradictory info about regarding E2 and penis sensitivity and also the use of AI's.

Any recommendations or suggestions? Should I go with the AI and get my E2 down to see if that helps?
 
#2
Was your estradiol measured with the sensitive, LC, MS/MS, lab test? It's the only e2 test that men can rely on. If the standard test was used, the infirmation is of no help to you and your doctor. If you don't know which test was ordered, post the reference ranges. They are a dead giveaway as to which test was run.

Actually, posting ranges for all tests is important. Every lab establishes different ranges.
 
#3
It seems like estrogen might be a problem, soft erections and sensitivity issues screams estrogen related and we can rule out low estrogen.

You should just lower your dosage and that should do the trick, AI's should be a last resort. Taking drugs always have consequences down the road, lowering the dosage doesn't.

I recommend lowering T dosage or HCG dosage and possibly switching to an EOD protocol, this should lower estrogen outright, no drugs needed. Your T levels will be steadier and estrogen lower. Really you don't want to inject more than 500 ius at a time, otherwise it's going right over to estrogen.
 
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#7
Your numbers are almost a carbon copy of mine to include blood levels and dosing. I was on twice weekly test shots and I take 200 IU of HCG daily. I am a high SHBG guy and have always had a sensitive E2 in the 40's. I also dealt with penis sensitivity issues that turned out to have zero to do with estrogen. Do NOT go on an AI until you have done a free E2 test on discounted labs. With your SHBG numbers I virtually guarantee your free E2 is in the normal range, in which case an AI will crash your E2 and you can be like the numerous guys on this board whose posts start with "Crashed my estrogen."

As a side note I did some advice only consults with Dr. C when he was with us and was counseled that he would never put me on an AI with those numbers. As it turns out I solved my penis sensitivity issues by moving to testosterone delivery systems with a much shorter half life - first Test cream applied to the scrotum and now Natesto. I believe my incredibly high trough levels - typically 1000-1200 were causing it. Now I have much more natural trough levels and my penis sensitivity and overall enjoyment of intimacy have returned to my pre low T levels. If you don't want to come off of injections I agree that a lower does of T may accomplish the same thing.
 
Thread starter #9
Was your estradiol measured with the sensitive, LC, MS/MS, lab test? It's the only e2 test that men can rely on. If the standard test was used, the infirmation is of no help to you and your doctor. If you don't know which test was ordered, post the reference ranges. They are a dead giveaway as to which test was run.

Actually, posting ranges for all tests is important. Every lab establishes different ranges.
I have been told it is the sensitive test. What range is the sensitive test usually? These are my labs. Note the units are different to what they refer to in the US. So I've been converting them before quoting.

Screenshot 2019-02-14 at 22.43.38.png
 
Thread starter #11
Your numbers are almost a carbon copy of mine to include blood levels and dosing. I was on twice weekly test shots and I take 200 IU of HCG daily. I am a high SHBG guy and have always had a sensitive E2 in the 40's. I also dealt with penis sensitivity issues that turned out to have zero to do with estrogen. Do NOT go on an AI until you have done a free E2 test on discounted labs. With your SHBG numbers I virtually guarantee your free E2 is in the normal range, in which case an AI will crash your E2 and you can be like the numerous guys on this board whose posts start with "Crashed my estrogen."

As a side note I did some advice only consults with Dr. C when he was with us and was counseled that he would never put me on an AI with those numbers. As it turns out I solved my penis sensitivity issues by moving to testosterone delivery systems with a much shorter half life - first Test cream applied to the scrotum and now Natesto. I believe my incredibly high trough levels - typically 1000-1200 were causing it. Now I have much more natural trough levels and my penis sensitivity and overall enjoyment of intimacy have returned to my pre low T levels. If you don't want to come off of injections I agree that a lower does of T may accomplish the same thing.
Thanks for the reply man. I'm based in the UK so we don't have as many options testing wise as you guys do in the states. I'll check re the Free E2 test.
 
Thread starter #12
It seems like estrogen might be a problem, soft erections and sensitivity issues screams estrogen related and we can rule out low estrogen.

You should just lower your dosage and that should do the trick, AI's should be a last resort. Taking drugs always have consequences down the road, lowering the dosage doesn't.

I recommend lowering T dosage or HCG dosage and possibly switching to an EOD protocol, this should lower estrogen outright, no drugs needed. Your T levels will be steadier and estrogen lower. Really you don't want to inject more than 500 ius at a time, otherwise it's going right over to estrogen.
Thanks. I'll try a lower dose. When I was on 50mg/wk my T was at 972ng/dl and E2 was at 22.8pg/mL. But that was in October last year so I have no idea whether the sensitivity would have been an issue then.
 
#13
I have been told it is the sensitive test. What range is the sensitive test usually? These are my labs. Note the units are different to what they refer to in the US. So I've been converting them before quoting.

View attachment 6818
You did not have the sensitive test. That's the range for women, your reported value is likely high, but the standard test can't be relied on by men. Symptom management is paramount.
 
#14
Your numbers are almost a carbon copy of mine to include blood levels and dosing. I was on twice weekly test shots and I take 200 IU of HCG daily. I am a high SHBG guy and have always had a sensitive E2 in the 40's. I also dealt with penis sensitivity issues that turned out to have zero to do with estrogen. Do NOT go on an AI until you have done a free E2 test on discounted labs. With your SHBG numbers I virtually guarantee your free E2 is in the normal range, in which case an AI will crash your E2 and you can be like the numerous guys on this board whose posts start with "Crashed my estrogen."

As a side note I did some advice only consults with Dr. C when he was with us and was counseled that he would never put me on an AI with those numbers. As it turns out I solved my penis sensitivity issues by moving to testosterone delivery systems with a much shorter half life - first Test cream applied to the scrotum and now Natesto. I believe my incredibly high trough levels - typically 1000-1200 were causing it. Now I have much more natural trough levels and my penis sensitivity and overall enjoyment of intimacy have returned to my pre low T levels. If you don't want to come off of injections I agree that a lower does of T may accomplish the same thing.
Where do you like your free E2 to be? And where does your free T sit now? I’m a high SHBG guy, so just curious.
 
#16
Thanks for the reply man. I'm based in the UK so we don't have as many options testing wise as you guys do in the states. I'll check re the Free E2 test.
Don't get too caught up in the whole "sensitive" E2 testing issue. You have what's available to you - immunoassay - snd that's more than good enough (I've had ~30 tests in London over the last 20 years and have found the E2 results to be both consistent and instructive).

My strong advice, as others have said, is don't take any AIs based on your Labs and an apparent lack of sensitivity.
Overall you've got quite high levels of all the sex hormones, which is fine as long as all are in balance.
Your FT is >2% of TT which is great news.

Your most recent E2 number is high(ish) and the most noticeable change from your earlier Labs is that then your E2 was ~0.2% of your TT and now it's ~0.4% of TT, which is high.
Some of that difference could be explained by inconsistencies but it's a big swing. Did you increase hCG or introduce anything new between the two draws.

The other two issues with sexual function, from a hormone perspective, are DHT and prolactin. DHT doesn't appear on the Labs you posted; many panels don't include DHT (but should in my view).
Healthy eugonadal men convert T to DHT at ~10% which would indicate for you a DHT level of around 4.2 nmol/L (120 ng/dl). That will be "above range", as are your other hormones, and would balance well your high(ish) E2.

Last, but not least, Sex. Is your new g/f practicing Kegels and really using it during intercourse.
Overcomes "lack of sensitivity", helps you get off and most women really like the sensation too.
 
Thread starter #17
Your most recent E2 number is high(ish) and the most noticeable change from your earlier Labs is that then your E2 was ~0.2% of your TT and now it's ~0.4% of TT, which is high.
Some of that difference could be explained by inconsistencies but it's a big swing. Did you increase hCG or introduce anything new between the two draws.
I increased my Test from 100mg/wk to 120mg/wk. HCG remained 1,500iu/wk throughout.

I'm thinking I'll go back to 100mg/wk but try the EOD protocol. So 30mg EOD (technically105mg/wk) and then reduce the HCG to 250iu EOD (875iu/wk).

What do you guys think? Am i making too many changes at once?
 
#18
I increased my Test from 100mg/wk to 120mg/wk. HCG remained 1,500iu/wk throughout.

I'm thinking I'll go back to 100mg/wk but try the EOD protocol. So 30mg EOD (technically105mg/wk) and then reduce the HCG to 250iu EOD (875iu/wk).

What do you guys think? Am i making too many changes at once?
Normally when making changes to a protocol it's best to make one change at a time in order to evaluate what's helping/hurting.

As the disproportionate rise in E2 happened when your only apparent change, between the two Labs, was an increase in the injectable T then the decrease to 105mg would seem reasonable.
It's surprising that the previous increase produced such a big rise in E2, then nothing is linear and there are few absolutes in this game.

Meanwhile, if it were me, I'd want to know my DHT level.
 
#19
Don't get too caught up in the whole "sensitive" E2 testing issue. You have what's available to you - immunoassay - snd that's more than good enough (I've had ~30 tests in London over the last 20 years and have found the E2 results to be both consistent and instructive).

My strong advice, as others have said, is don't take any AIs based on your Labs and an apparent lack of sensitivity.
Overall you've got quite high levels of all the sex hormones, which is fine as long as all are in balance.
Your FT is >2% of TT which is great news.

Your most recent E2 number is high(ish) and the most noticeable change from your earlier Labs is that then your E2 was ~0.2% of your TT and now it's ~0.4% of TT, which is high.
Some of that difference could be explained by inconsistencies but it's a big swing. Did you increase hCG or introduce anything new between the two draws.

The other two issues with sexual function, from a hormone perspective, are DHT and prolactin. DHT doesn't appear on the Labs you posted; many panels don't include DHT (but should in my view).
Healthy eugonadal men convert T to DHT at ~10% which would indicate for you a DHT level of around 4.2 nmol/L (120 ng/dl). That will be "above range", as are your other hormones, and would balance well your high(ish) E2.

Last, but not least, Sex. Is your new g/f practicing Kegels and really using it during intercourse.
Overcomes "lack of sensitivity", helps you get off and most women really like the sensation too.
I second the kegel advice. My wife has been doing them for years and it is amazing what it does for sensitivity during intercourse. It literally tips you and squeezes you while you thrust. Great for he and, I think, even better for you. Get your woman to do it. You won’t be sorry.
 
#20
Guys. I’ve struggled with this also. When I spoke with my doctor about this he prescribed me an extremely low dose cream 5mg per .1 ml and I apply it to my penis twice a day, like a scrotal cream. It comes in a little pen type bottle. I swear to God it’s like being a teenager again and the dose is low enough that it has not affected my overall numbers at all. I think it has something to do with DHT conversion in the skin maybe but all I know is that it works and hasn’t increased my DHT or anything out of proportion. Oh and I tried adjusting everything from hCG trying to play with my estrogen, etc. 10 years on TRT and this is the only thing that brought sensitivity back to the way it was when I was young.

This comes from Healthy Choice compounding pharmacy in Elmsford New York.
 

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