Current TRT Patient (Defy) - Which Labs Should I Order for Sexual Dysfunction

Donovan P

New Member
I have been on Test Cyp (70mg IM twice weekly) and HCG (500 IU SQ twice weekly) since 09/2018. These dosages have put my trough TT between 752-1174 ng/dl and trough FT between 23.2-32 pg/dl. My Estradiol (sensitive) on these dosages has always been 20-25.

The problem prompting this post is that I go through wild cycles of several weeks where sexually, things are absolutely unbelievable, and then that is followed by several weeks where things are as bad or worse as they were before I began treatment. The disparity in the peaks and valleys is nearly inarticulable and more than one partner has said something about this to me as well.

At my last Defy appointment back in June 2019, my sexual health was excellent. For approximately the entire months of June and July, my sex drive was through the roof, my erections were incredible, orgasm quality was unbelievable, and overall my satisfaction (and partners’ satisfaction) had never been any better.

Things have absolutely cratered the past several weeks.

Perhaps most notably, when "things are bad", the sensitivity of my penis and scrotum diminish dramatically. Though my desire for sex is still high (though not as “through the roof” high as when things are good), I do not get nearly as aroused during sexual interaction, in large part because when I receive oral sex and engage in most sex positions, I don’t feel anything. If I am not in one of select few sex positions that I enjoy the most, I risk losing the erection (to the degree I have one at all) entirely because it literally doesn’t “feel like anything”. I then have to forcefully masturbate to get back to where I was.

When things are bad, when engaging in foreplay and intercourse, my penis does get larger than it is in its totally flaccid state. However, it never gets “all the way there”. In addition, it does not stiffen to a degree commensurate with the increase in size. It’s almost like my penis is hollow. Not only is it not rigid; it is significantly pliable. It actually feels like it is dead, insofar as there is no pulsating, no throbbing, no quivering, no involuntary contractions occurring. It's just not full. It's like I get to 80% of the size of my ultimate erect state when "things are good", but the degree to which it engorges is much less than that. When things are good, it's almost like my penis has its own heartbeat, and when things are bad it's flatlined.

There have been several cycles like this since I started the treatment back in 09/18 where for several weeks things are absolutely unbelievable and then that is followed by several weeks where, sexually, things are as bad or worse as they were before I began treatment. Overall, even when things are bad, my libido is higher than it was before I began treatment. However, the issues with penile and scrotal sensitivity never occurred prior to starting the treatment. The weird delta between increase and size and stiffness in the aroused state is not something I encountered prior to treatment.

Though it is possible for me to reach orgasm when things are bad, I can only do so through forceful masturbation. The orgasm quality is very poor. It lasts for a split second, is not intense, and I do not experience anything near the warm-all-over, intense full-body, nearly overwhelming sensation that I get when ‘things are good’.

There are other substantial differences. When things are good, I produce an extraordinary amount of pre-cum. When I eventually ejaculate, there is a very significant amount of fluid, and it is expelled extremely forcefully. Like a cannon. Conversely, for the past several weeks, the amount of pre-cum produced during foreplay and intercourse is almost none. The amount of fluid expelled during ejaculation is very minimal, and it is a weak dribble, not a forceful shot. I almost have to “kegel it out”, or clench it out.

Tadalfil does not seem to be helping me at all. I have tried taking as much as 25mg and it has not made a difference when things are bad. In general I take 5mg daily, but I do not believe it is affecting things. I also use L-Citrulline Malate 2:1, experimenting with dosages between 2000mg and 10,000mg. Doesn't make a difference.

I'm 28 years old, 5'9, 182 lbs, active (lifter). Non smoker, minimal to no alcohol, no drugs / tobacco. What do I do?


Normally when checking on my progress I check Total T, FreeT, SHBG and estrogen. If you want to dig deeper, do a thyroid panel and a mineral panel checking all the core vitamins, iron and ferritin wouldn't be a bad idea.

HCG can cause problems with mood, libido and erectile strength. Cialis can lower estrogen as well.

Have you ever tried TRT in isolation?

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