Sexual Function, Mood and Drive. DHT and E2.

Thread starter #1
I'm fairly new to the Forums and have been researching primarily to plan my future protocol in hormone therapy. Previously I have used direct DHT treatment by way of Proviron (mesterolone) which I had prescribed in the UK, my home country, and is available to me o.t.c. where I live now.

My own long held belief, from personal experience, is that for sexual function (libido & EQ) mood and drive the most important factors, from a hormonal perspective are an adequate level of T and the balance of DHT and E2. T, in this context, is merely the prohormone.
There is a lot of discussion, and use in studies, of T:E2 ratios. My own preoccupation is with the DHT:E2 ratio in the presence of adequate T - in the absence of adequate T the ratio of the 2 metabolites is moot.

The main advantage to me of supplementing DHT (the strongest of the androgens) separately is the flexibility to allow it's levels to fluctuate, along with the associated levels of Dopamine, whilst maintaining T and E2 relatively stable. To put some numbers to the theory my TT is normally around 800 and my E2 ~30. SHBG averages around 40. To feel at my best I need my DHT to be between 80 and 110 (ie around the top end, or just over, of most ranges). I know from experience that at those sort of levels my 5a-r conversion is around 8 or 9% of TT. So I need to supplement DHT and I titrate the amount up and down according to occasion.
Therefore the ratio of DHT:E2 (ng/dl to pg/ml) fluctuates around 3or4:1

It's my subjective belief that DHT, like Dopamine, works best when it is in flux and at adequate levels. Having that hormone and the associated neurotransmitter, together with E2, working in synergy is particularly beneficial for sexual function, mood and drive.

Most TRT protocols involve a regimen of injectable T plus an AI "if needed" (leaving aside hCG for now). I would postulate that many patients would have a better outcome, and avoid the need for an AI entirely, by injecting a lesser amount of T with the addition of direct DHT supplementation.

The "need" for an AI is created by sending E2 too high in the first place (by the use of too much aromatisable T). How much better, where efficacious, to use less T plus DHT thereby lessening the potential for high hematocrit, raised blood pressure and (worse still) raised prolactin.

It is encouraging to me to see the success that numerous guys are reporting in using T Cream direct to the scrotum to elevate DHT levels. Looking from across the pond it appeared, at first sight, that the FDA's prohibition of DHT products (no Proviron or Andractim) would disadvantage patients in hormone therapy. However it now seems that this "workaround" method of raising DHT is particularly effective and has a beneficial systemic effect.

The question that interests me here is whether, in addition to the systemic effect, the T Cream applied to the scrotum is having a local effect in the testes ie is it possible that there is an effect on intratesticular aromatase? If it is possible that this strong androgen can somehow dissipate the localised aromatase then could this have potential as an adjunctive therapy for patients using hCG? (DHT cream does have a local effect in treating gynaecomastea).
 
Thread starter #3
For sure. "Back in the day" before the advent of arimidex and aromasin Proviron was used for that purpose as it binds preferentially with the receptors.
 
#5
I don’t have the answers to your questions. I’m just speculating at this point. Seems logical if we could add a compound which would allow the lowering of the T dose. Obviate the need for an AI and possibly increase libido, perhaps we could kill two birds with one stone. I think most of the bad rep that proviron and other anabolics get are from abuse and not reasonable use.
 
#6
I don’t have the answers to your questions. I’m just speculating at this point. Seems logical if we could add a compound which would allow the lowering of the T dose. Obviate the need for an AI and possibly increase libido, perhaps we could kill two birds with one stone. I think most of the bad rep that proviron and other anabolics get are from abuse and not reasonable use.
To that end DHT has been demonized with Prostate and hair loss, among others.
 
Thread starter #9
I actually think the future of TRT will be some combination of testosterone and another androgen that does not aromatize. The benefits seem to be the ability to use less T and reducing the need for an AI.
Exactly that. And you put it far more succinctly than I managed!
I see incresing DHT as the best candidate - the strongest of the androgens it can't aromatise and binds preferentially with the E2/SHBG receptors allowing more free T.

I don't think physicians will rush to design protocols that deliberately raise DHT though (if they are, understandably, cautious about TRT treatments they'll likely be 5x more cautious with DHT therapy).
 
Thread starter #11
Would 25mg of proviron daily be a good starting point to evaluate?

I'm guessing having bloods for DHT, SHBG, TT, and E2 are necessary to monitor.
Not sure from your post if you're on a protocol and are shutdown?
If you are and therefore any potential suppression isn't an issue then starting with a low dose, as you say, and evaluating would seem ideal.

For sure include DHT in your bloods. Although serum levels of DHT appear only to give an indication of activity at receptor/in tissue, personally I have long been persuaded by by the 1995 Greek study that showed serum level of DHT to be the only reliable predictor of orgasm frequency.
More important than bloods is your subjective response and improvement of symptoms that can be alleviated by adequate levels of DHT.
 
Thread starter #13
Hmmm
So how do you dose the Proviron?
How much do you use?
I've used (prescribed) Proviron for ~20 years.
On average I would use 150mg per day (6 x 25mg tabs) which I believe normally elevates the serum level of DHT by about 20 to 25ng/dl.
To add really significant amounts you'd need a lot of tabs: each tab is around 25 cents. It will also displace E2 and SHBG at the receptor which could be a good or bad thing depending on overall hormone profile. Before the days of PDE5i's Proviron was used in Europe to treat ED (how effectively I don't know).

As I recall you did a short-term test over the Holidays by using some of your T Cream direct to the Scrotum. Did you continue? If you have your prescriber's OK to apply in that manner it could be worth doing over a prolonged period to see if the disproportionate conversion to DHT brings relief of symptoms.
 
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#14
I've used (prescribed) Proviron for ~20 years.
On average I would use 150mg per day (6 x 25mg tabs) which I believe normally elevates the serum level of DHT by about 20 to 25ng/dl.
To add really significant amounts you'd need a lot of tabs: each tab is around 25 cents. It will also displace E2 and SHBG at the receptor which could be a good or bad thing depending on overall hormone profile. Before the days of PDE5i's Proviron was used in Europe to treat ED (how effectively I don't know).

As I recall you did a short-term test over the Holidays by using some of your T Cream direct to the Scrotum. Did you continue? If you have your prescriber's OK to apply in that manner it could be worth doing over a prolonged period to see if the disproportionate conversion to DHT brings relief of symptoms.
What country are you in?
 
#15
I am going into "Crash Test Dummy" mode:)
I have enough old labs to get a good idea of baseline with 2 clicks under the arm.
I am going to get Free "T", E2 Sensitive, DHT, PSA (Log story) and maybe SHBG in the AM prior to application of the cream.
Then I will switch to scrotal applications of 2 clicks daily for a few week and run the same labs again and see if there is any apparent changes.
 
Thread starter #16
What country are you in?
Home country is England where Proviron was prescribed. Big chunk of the year I live in Morocco where it's o.t.c.
Don't know what the chances of it getting licenced in US are. Probably not great as it's been generic for years and is cheap as chips so commercially unlikely. Maybe physicians would lobby the FDA. Seems like your regulator has a downer on DHT.
 
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