Issues ED and TRT

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JamesonD

New Member
Gentlemen,
I'm glad I found this group there's been a lot to learn so far and the forum has been an informative resource. Here's my story. I'm 43 and have I've been on TRT for around 1.5 years and have not had much success in consistently getting the erections I had Pre-TRT. My libido is through the roof but performance is seriously lacking. When I do get an erection that's suitable, its only a matter of time before I lose it. Along with ED issues, there is also a serious lack of sensitivity and extreme difficulty in achieving orgasm. I use Cialis or Viagra from time to time and it helps out minimally. I've mentioned this the whole time to my TRT Dr. at the clinic but she only suggested using Dim, taking vitamins, etc and says all my values are normal. I will be making changes to the clinic I visit soon because of the lack of help I've received thus far. I've also seen a Urologist who's also reviewed my bloodwork and see's no issues. My prostate checks good and normally sized along with a low PSA value. I did tell the urologist about my feeling of not being able to completely empty my bladder when urinating and they checked and confirmed that I'm still holding on to a few ounces. When I urinate it normally is a weak stream. The doctor had me go on Flomax, but it did not help. He believed my problem to be pelvic floor tension and suggested I do physical therapy. I did 6 weeks of physical therapy without improvement in urine voiding or erection quality. I feel there might be some relationship between erection quality and the urine voiding issue but I feel it may be more to do with other issues related to estrogen management, etc. My past bloodwork has always shown low SHBG usually in the high teens. My most recent bloodwork this past month is as follows:
Estradiol, serum 35.4 (standard estradiol test not ultra sensitive) Prolactin 26.0, DHEA Sulfate 181.1, Testosterone 652, (range 249-836) Free Testosterone 168.5 (Range 48-250) Free/Total Testosterone % 2.6 (range 1.3-2.9) SHBG 24.2, DHT 426. T4 1.42, T3 2.79. All other values within normal ranges on CBC.

Other info: 43 year old male, 6'2 Weight 195lbs, I'm in relative good shape otherwise.
Any help would be greatly appreciated. My current protocol is 150mg testosterone cypionate divided into 2 shots weekly with HCG 400IU taken 3x weekly.

Any help would be greatly appreciated.
Thank you
 
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Systemlord

Member
I can tell you when my estrogen is high, my erections are either soft and difficult to maintain or non-existent. Also if my Free T drops below the very top of the ranges, I feel the same as I did pre-TRT, you need to find the range at which you respond well.

When I was on a twice weekly protocol, I responded poorly to TRT and didn't start responding well until I started an EOD protocol, only 2 weeks into it, muscle were firming up.

You don't even have the correct E2 labs. Free T3 is barely midrange.

Optimal vs Normal Thyroid Levels for All Lab Tests & Ages
 
Last edited:

JamesonD

New Member
I can tell you when my estrogen is high, my erections are either soft and difficult to maintain or non-existent. Also if my Free T drops below the very top of the ranges, I feel the same as I did pre-TRT, you need to find the range at which you respond well.

When I was on a twice weekly protocol, I responded poorly to TRT and didn't start responding well until I started an EOD protocol, only 2 weeks into it, muscle were firming up.

You don't even have the correct E2 labs. Free T3 is barely midrange.

Optimal vs Normal Thyroid Levels for All Lab Tests & Ages
I’ve requested the sensitive estradiol test twice before on blood tests and was never able to get it which I why I have to change my clinic. What is the correlation between the regular estradiol test and the sensitive? Is the regular test that far off to not be reliable?
 

Systemlord

Member
The regular estradiol test picks up on other steroids (C-reactive protein linked to inflammation) and estrogen is often inflated, the sensitive method doesn't have this limitation.

The non-sensitive E2 test can be unreliable. A lot of these Low T Centers and Clinics have some other doctors writing the scripts and often have no idea what they are doing.
 

S1W

Well-Known Member
Looking at your numbers, I would say raising TT/FT might be worth a shot. Yes, E2 will go up but that might not be the issue - it wasn’t for me.

I’m not exactly sure what my issue is but I don’t get much benefit from TRT until I’m at the top of/above normal ranges for TT/FT. This also brings my E2 high out of range, but for whatever reason this works for me. For reference, my SHBG is a point lower than yours.
 

JamesonD

New Member
I’m thinking a revamp of my protocol is probably necessary. I’m thinking Sub-Q and going EOD or every 3x per week. The general consensus for low SHBg guys is to increase frequency and to do sub-q to get the benefit of higher testosterone levels and lower E2 conversion. I really need to get on top of the ED it’s getting pretty bad. Hoping for the best with the new protocol.
 

Nighthawk

New Member
I can tell you when my estrogen is high, my erections are either soft and difficult to maintain or non-existent. Also if my Free T drops below the very top of the ranges, I feel the same as I did pre-TRT, you need to find the range at which you respond well.

When I was on a twice weekly protocol, I responded poorly to TRT and didn't start responding well until I started an EOD protocol, only 2 weeks into it, muscle were firming up.

You don't even have the correct E2 labs. Free T3 is barely midrange.

Optimal vs Normal Thyroid Levels for All Lab Tests & Ages
Systemlord, Can you tell me what your entire protocol is now? I've read a lot of your posts and seem to be a lot of similarities. I am very "different" in the way my body resonds to anything I put in it. Thanks!
 

Systemlord

Member
Systemlord, Can you tell me what your entire protocol is now? I've read a lot of your posts and seem to be a lot of similarities. I am very "different" in the way my body resonds to anything I put in it. Thanks!

I recently went back to 20mg cypionate EOD as 21mg EOD enanthate saw my levels significantly lower and I didn't need labs to confirm, sleep was poor, muscles softer and the feeling of being low T is all too familiar to me, plus I didn't have any estrogen sides which would mean Free T levels were lower.

It seems I'm very sensitive to even moderate doses that cause estrogen sides, daily injections was a big difference except for one reason or another, my liver couldn't process toxins quick enough on daily injections.

On a daily protocol erections were approaching exceptional in less than a week and sleep improved dramatically with in 2-3 days I believe was do to smaller peaks and troughs and lower estrogen which was confirmed by labs at 26 pg/mL. I always remember others saying how sleep suffers when estrogen is high.
 
Last edited:

seb288

Member
Systemlord, what was the protocol that worked beautifully for you? I know frequency was daily but what about ester and dosage?
(e.g. 10mg propionate/day, 12mg enanthate/day, 12.5mg cypionate/day)

Do you know what your libido, energy, mood, confidence, total test, free test and shbg were?

And finally, how did you do daily injections - must be a lot of wasted syringes, needles and test oil right?

Sorry for so many questions!
 

Guided_by_Voices

Well-Known Member
Just seeing this..several comments. OP: your test dosage is almost double mine and I do not do well above about 90 per week so my immediate question is did you start at a lower dose first? Also, are you on DHEA? It makes a big difference for me and others here as well. Did you try clomid at a low dose or HCG monotherapy before you started TRT? Have you had your thyroid checked? Those are all things to consider.
 

Systemlord

Member
Systemlord, what was the protocol that worked beautifully for you? I know frequency was daily but what about ester and dosage?
(e.g. 10mg propionate/day, 12mg enanthate/day, 12.5mg cypionate/day)

Do you know what your libido, energy, mood, confidence, total test, free test and shbg were?

And finally, how did you do daily injections - must be a lot of wasted syringes, needles and test oil right?

Sorry for so many questions!
Insulin syringes waste no amount of Test and 29G insulin syringes are $12 per 100 syringes. Right now I'm injecting 24mg cypionate EOD, was doing 7mg daily until I was forced to stop do to aforementioned issues.
 
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