6 months into TRT, sex issues

[sirgawain]

Hi all! I just found this forum.

I am in my 50's, I started TRT back in May. I tested at 500, but my free T was quite low, so we started a 170 once a week protocol with an AI the next day. After 2 months, T jumped above 1000, free looked great, and AI was increased. I just did new bloodwork, numbers are around the same, but my RBC is a little high. I speak with my doctor later this week about the results.

One major topic has been that while the TRT has helped change my body comp, and combined with a daily Cialis, I get good morning wood, my libido and my ability to orgasm (or sometimes hold the erection) has decreased this year over time. I'm not sure if it's AI related, if I need HCG, or what, but the past few weeks, my wife and I will start something in the AM and I can go and go for 15 mins and nothing -- it's like I don't feel anything. And most of the time, libido is just a big "meh." Not quite what I was hoping for.

Anyway, I know this is a process, and hopefully we can get it dialed in. Right now, I'm frustrated.

 

[ERO]

Its not likely to solve the libido issue all by itself, but a once a week shot is an out of date protocol for the most part. Your T levels will be more stable if you take half your weekly dose every 3.5 days, so like Monday AM, and Thursday PM.

What is your AI dose? A little goes a LONG way.

 

[mooseman109]

My guess would be high E2.. Based upon your description, that is what happens to me with high E2

 

[sirgawain]

Its not likely to solve the libido issue all by itself, but a once a week shot is an out of date protocol for the most part. Your T levels will be more stable if you take half your weekly dose every 3.5 days, so like Monday AM, and Thursday PM.

What is your AI dose? A little goes a LONG way.

We started at .5, then moved to .75, weekly a day after the shot. (Armidex)

And my last E2 number (this week) was 39. I started at 25, 2 months later was at 35, then we upped the AI, and now I am at 39.

 

[ERO]

If your Total T is above 1000, then 39 is not really high E2. That would be High E2 if your total T was like 600-700.

 

[UCFguy01]

I personally think your E2 is fine where it's at. Maybe adding some HCG would help with libido. HCG has that effect on some people.

 

[MarcoFL]

Hi all! I just found this forum.

I am in my 50's, I started TRT back in May. I tested at 500, but my free T was quite low, so we started a 170 once a week protocol with an AI the next day. After 2 months, T jumped above 1000, free looked great, and AI was increased. I just did new bloodwork, numbers are around the same, but my RBC is a little high. I speak with my doctor later this week about the results.

One major topic has been that while the TRT has helped change my body comp, and combined with a daily Cialis, I get good morning wood, my libido and my ability to orgasm (or sometimes hold the erection) has decreased this year over time. I'm not sure if it's AI related, if I need HCG, or what, but the past few weeks, my wife and I will start something in the AM and I can go and go for 15 mins and nothing -- it's like I don't feel anything. And most of the time, libido is just a big "meh." Not quite what I was hoping for.

Anyway, I know this is a process, and hopefully we can get it dialed in. Right now, I'm frustrated.

really need to see your full labs.

 

[sirgawain]

Okay, relevant numbers out of CBC:

RBC was high (5.95). Will donate blood to drag that down.
Hematocrit was 50.7.

Test: 1079
Estradiol: 39.1
SHBG: 41.7

Had my consult today, wants to up the AI to 1 from .75, target range of 15-30 on Estradiol. Believes that number is what is driving my libido/sensitivity issues.

So that's where I'm at.

 

[Ronnny]

One major topic has been that while the TRT has helped change my body comp, and combined with a daily Cialis, I get good morning wood, my libido and my ability to orgasm (or sometimes hold the erection) has decreased this year over time.

what dose cialis do you take every day?

 

[sirgawain]

what dose cialis do you take every day?

5mg.

Update: doc wants to increase my AI

 

[madman]

Okay, relevant numbers out of CBC:

RBC was high (5.95). Will donate blood to drag that down.
Hematocrit was 50.7.

Test: 1079
Estradiol: 39.1
SHBG: 41.7

Had my consult today, wants to up the AI to 1 from .75, target range of 15-30 on Estradiol. Believes that number is what is driving my libido/sensitivity issues.

So that's where I'm at.

Although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

You need to be more concerned with where your FT level sits on such protocol!

Post labs for FT (assay used/reference range).

An SHBG in the low 40s is not that high and unless you had your FT tested using the most accurate assay such as Equilibrium Dialysis or Ultrafiltration then for all we know your FT may very well be too high.

 

[sirgawain]

My labs don't have FT, I believe he just calculates it since I can't see it on the lab results.

 

[madman]

My labs don't have FT, I believe he just calculates it since I can't see it on the lab results.

You need to look into having it tested using an accurate assay if you want to know where your FT level truly sits on such a protocol.

Trust me when I tell you that there is such a thing as too high FT level which will result in too high e2/free e2 for some let alone increased RBCs/hemoglobin/hematocrit.

The goal is to find an FT level that allows you to reap the beneficial effects of testosterone while at the same time avoiding/minimizing any potential negative side-effects.

Most men will do well with an FT level in the 20-30 ng/dL range and many tend to aim for the higher end or in some cases run higher levels.

It comes down to the individual as some men can run higher levels without any issues whereas others will struggle.

It would be in your best interest to take this into your own hands and have your FT tested using the most accurate assay.




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[sirgawain]

You need to look into having it tested using an accurate assay if you want to know where your FT level truly sits on such a protocol.

Most men will do well with an FT level in the 20-30 ng/dL range and many tend to aim for the higher end or in some cases run higher levels.

It comes down to the individual as some men can run higher levels without any issues whereas others will struggle.

It would be in your best interest to take this into your own hands and have your FT tested using the most accurate assay.

I checked the notes section and apparently it's 23.4, which looks like it's calculated off of a default Albumin score. Why they don't just test for it overall, I don't know, but that still puts me at the low end fo that. How does one *increase* the free T?

 

[madman]

I checked the notes section and apparently it's 23.4, which looks like it's calculated off of a default Albumin score. Why they don't just test for it overall, I don't know, but that still puts me at the low end fo that. How does one *increase* the free T?

Doubtful your FT level is on the low end with a TT 1000+ even with SHBG in the low 40s.

I would not rely on the calculation method used and you need to have it tested using an accurate assay otherwise you have no idea where it truly sits let alone you are wasting your time tweaking your protocol based on your just your TT/e2 when FT is what truly matters.

 

[madman]

I checked the notes section and apparently it's 23.4, which looks like it's calculated off of a default Albumin score. Why they don't just test for it overall, I don't know, but that still puts me at the low end fo that. How does one *increase* the free T?

Looking over your first post where you stated that you were started on a once-weekly injection of 170 mg T and 2 months later blood work showed TT in the 1000s and FT looking great.

Was blood work done at the true trough?

 

[madman]

You were started on a cookie-cutter protocol.

High dose T 170 mg/week with an AI thrown in off the hop.

The downfall of injecting once weekly is TT/FT levels will be very high post-injection 8-12 hrs and elevated during the first few days of the week only to be followed by much lower levels come weeks end.

This can have a negative effect on symptom relief and result in a roller coaster effect when it comes to energy/mood/libido/erections.

Always best to start on a T only protocol so you can see how your body will react.

 

[madman]

How many days after your injection did you have blood work done?

 

[Willyt]

I had exact same problem. You may also want to look at your DHT. Mine was on low end. Defy prescribed T scrotal cream to increase DHT and to supplement the cypionate injections, which provide the steady baseline T.

The addition of cream has definitely helped my libido about 3-4 hours after application. Quite a few people on this forum use a combo-type approach.

 

[madman]

Hi all! I just found this forum.

I am in my 50's, I started TRT back in May. I tested at 500, but my free T was quite low, so we started a 170 once a week protocol with an AI the next day. After 2 months, T jumped above 1000, free looked great, and AI was increased. I just did new bloodwork, numbers are around the same, but my RBC is a little high. I speak with my doctor later this week about the results.

One major topic has been that while the TRT has helped change my body comp, and combined with a daily Cialis, I get good morning wood, my libido and my ability to orgasm (or sometimes hold the erection) has decreased this year over time. I'm not sure if it's AI related, if I need HCG, or what, but the past few weeks, my wife and I will start something in the AM and I can go and go for 15 mins and nothing -- it's like I don't feel anything. And most of the time, libido is just a big "meh." Not quite what I was hoping for.

Anyway, I know this is a process, and hopefully we can get it dialed in. Right now, I'm frustrated.

If these are your trough numbers then your TT/FT/e2 levels are going to be much higher earlier in the week!

Seeing how you stated that your RBCs/hemoglobin/hematocrit is high then you can rest assured that your FT level is too high.