Penile fibrosis after long time without morning erections?

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rustylwb

Member
Hello everyone,

I ve been struggling with ed since 2018 after stopping a testosterone cycle. I am on trt for a year (tried for a long time to recover with serms) and except for the honeymoon period i always struggled with ed. I ve tried many doses with different injection frequencies. With ai and without. With hcg and without. Right now i am on 200mg M/W/F and my t is 1050ng/dl with shbg 40. For a couple of months i have started daily cialis and to my surprise it brought back something i hadnt felt since all this started. Morning erections (not full erections, more like semi erect). My Libido is good but even on daily cialis my erections are not full. Cant take more than 5mg daily cause my blood pressure drops too much. I am 33 years old

I am wandering if the lack of morning wood and in general erections for all this time (since 2018) has caused some damage to the penis (like fibrosis) and thats why even with cialis (or viagra) i cant get a full erection (even though my libido is ok).
My testosterone levels or any hormone for that matter are definitely not the issue (i ve done more than 15 bloodworks and i've seen the all over). I did a penis ultrasound about a year ago and while even with the injection i only reached like 60% erection, the doctor said that my bloodflow is fine. does fibrosis appear on that test?. Could my issue be caused by lack of erections for a long time or should i look elsewhere?

Thanks in advance
 
Defy Medical TRT clinic doctor

rustylwb

Member
Something else is going on. Did you check your thyroid? Have you ever used Finasteride? At 33, you shouldn't have long term damage to your penile tissue. Did you have other erections other than nocturnal? What about E2? Those are some pretty high levels of T you are running right now. Also check prolactin.
I noticed the finasteride. I'm taking it for hair loss and have for about two months. Maybe it is affecting my sex drive but until today I have tried to not think about it. I did read about it when I started. It said it can stop your sex drive. Is that why you are asking about it? My sex drive has taken a nose dive and ed also. I have blue and yellow pills but they aren't working all that well. About a 3/4 erection. I'm on Gel and liquid runs my red count up like a rocket. I've used the test for several years. I'm 77 but workout almost ever day weight & bike
 

DorianGray

Active Member
A doppler ultrasound is the gold standard for diagnosis of venous leakage and I feel it should be interpreted by a vascular specialist or competent urologist not a GP. You seem too young to have the other venous conditions the previous poster describes. Usually those things creep along slowly which is why they manifest in 60s-70s. As others have posted elsewhere from time to time, TRT decreases erection quality and libido. I'm one of them and have experienced it being on and off TRT multiple times. Currently, off and libido has returned to satisfactory point whereas on, it was about non-existent. About the porn/mast, every other day is too much. I know it's very, very (you can do it!) difficult but you should try total abstinence for two weeks and no sex for two weeks, nothing. Then, give it the slow affectionate approach with gf/wife. See if it's different. If not, I'd repeat the Doppler and discuss with a good uro.
 

Tn198989

Member
A doppler ultrasound is the gold standard for diagnosis of venous leakage and I feel it should be interpreted by a vascular specialist or competent urologist not a GP. You seem too young to have the other venous conditions the previous poster describes. Usually those things creep along slowly which is why they manifest in 60s-70s. As others have posted elsewhere from time to time, TRT decreases erection quality and libido. I'm one of them and have experienced it being on and off TRT multiple times. Currently, off and libido has returned to satisfactory point whereas on, it was about non-existent. About the porn/mast, every other day is too much. I know it's very, very (you can do it!) difficult but you should try total abstinence for two weeks and no sex for two weeks, nothing. Then, give it the slow affectionate approach with gf/wife. See if it's different. If not, I'd repeat the Doppler and discuss with a good uro.
Was looking forward to your response.

I ve had a penis doppler ultrasound and a simple penis ultrasound, the doppler was done by a urologist/andrologist and the simple ultrasound was done by an endocrinologist/andrologist.

Don't remember if I mentioned it earlier but during the doppler after the injection I only reached like 60% erection but the doc said that it's enough to check for blood flow.

Ever since I stopped the steroid cycle in 2018 I immediately started clomid which I later found out that although it raises testosterone, it also drops libido because it completely blocks estrogen in the brain.

All this years from November 2018 until June 2021 when I started trt I didn't stop serms for more than a month. They gave me libido for a couple of days when they kicked in and then nothing. I would even reach test levels of 900ng/dl only with clomid but still Ed and low libido.

On trt at first I got the honeymoon period which lasted for a couple of weeks and I had high libido still not great erections but better, and high confidence, mood.

That was at a dose of 125mg per week which gave me total t of 650ng/dl.so after the crush I would increase the dose trying to recreate the situation.

My natural testosterone before the cycle was 500 with shbg 20 and my libido and erections were perfect.

Maybe I should drop the dose to get a lower testosterone level although I don't understand how a high testosterone level can cause Ed if e2 is controlled.

About the porn I ll try to abstain it for 2 weeks and see how it goes
 

Funkodyssey

Active Member
Is there an explanation why it happens if all other hormones are in check?
I think it involves E2 that is too high and too much activation of the sympathetic nervous system which is a stressor. I don't think it involves testosterone itself because that seems basically inert when it comes to libido. And I don't think DHT is the problem because if we've learned anything from cream users, massive DHT seems to be strictly helpful for libido.
 

Tn198989

Member
I think it involves E2 that is too high and too much activation of the sympathetic nervous system which is a stressor. I don't think it involves testosterone itself because that seems basically inert when it comes to libido. And I don't think DHT is the problem because if we've learned anything from cream users, massive DHT seems to be strictly helpful for libido.
I ve seen my e2 all over, high, mid range, low during trt. Secondly just to be clear for anyone in a similar situation. I am not talking about the effects on libido but erectile function.

It's difficult to distinguish sometimes but they don't happen always together. Right now my libido is normal high but even now if I watch my favourite porn even on daily cialis I won't be 100% erect (more like 70% tops) and I ll lose it immediately without stimulation.

Every blood test and ultrasound can't explain it. It seems I always read about another hormone that could be the cause, first I thought e2, then prolactin, then high shbg (so low free t), then thyroid function but I can't seem to figure it out. One thing I ve never checked is cortisol but I don't if that could cause that even when not anxious at all.
 

Simbarn

New Member
Was looking forward to your response.

I ve had a penis doppler ultrasound and a simple penis ultrasound, the doppler was done by a urologist/andrologist and the simple ultrasound was done by an endocrinologist/andrologist.

Don't remember if I mentioned it earlier but during the doppler after the injection I only reached like 60% erection but the doc said that it's enough to check for blood flow.

Ever since I stopped the steroid cycle in 2018 I immediately started clomid which I later found out that although it raises testosterone, it also drops libido because it completely blocks estrogen in the brain.

All this years from November 2018 until June 2021 when I started trt I didn't stop serms for more than a month. They gave me libido for a couple of days when they kicked in and then nothing. I would even reach test levels of 900ng/dl only with clomid but still Ed and low libido.

On trt at first I got the honeymoon period which lasted for a couple of weeks and I had high libido still not great erections but better, and high confidence, mood.

That was at a dose of 125mg per week which gave me total t of 650ng/dl.so after the crush I would increase the dose trying to recreate the situation.

My natural testosterone before the cycle was 500 with shbg 20 and my libido and erections were perfect.

Maybe I should drop the dose to get a lower testosterone level although I don't understand how a high testosterone level can cause Ed if e2 is controlled.

About the porn I ll try to abstain it for 2 weeks and see how it goes
How long were you on AAS for? More than one cycle?

In your first post you have said you tried many times to recover with SERM’s, but it appears from what you have just said that you took Clomid almost constantly after that cycle until you started TRT? From what I could understand, you only had a month off all these drugs before you decided to take TRT? Was this all under a doctor’s care? Has a doctor been instructing you to increase your dose of T up to 200mgs per week?
It looks like you did not try and stop all medications and let your body find its own homeostasis for a period of 6 months or more after the trials on Clomid?

Did you do a very slow gradual taper of Clomid before you stopped the SERM therapy? This is quite important.
Perhaps you could describe exactly what you have done with these restarts, the time periods and when TRT was initiated.

It can sometimes take 6 months to a year for some guys to return to normal function after using AAS, depending on the amount of cycles they have done and the length of those cycles? Sexual function can be all over the place for some time after these restarts and anabolic steroid use.

Clomid, owing to its Zuclomiphene component does interfere with sexual function in some men. This isomer of Clomid also builds up in the body and can continue to cause sexual difficulties post DC of the drug. It can cause issues with erectile function and sexual sensation in the penis itself for some time. Enclomiphene citrate is supposed to eliminate some of these issues. These drugs have varied effects on different men. We all have our own unique biochemistry that can respond well or not so well with these chemicals, as it can with any drug we put into our system.

You also mention you have record of a test showing you had a level of T at 500 before steroid use. At this time you are almost double that on TRT. It is no wonder IMO that your sexual function is not working well.

I see you have constantly tried to replicate the “honeymoon period” by increasing dosages. Often the honey moon period happens because of the sudden surge in testosterone and its effects on dopamine and fresh androgen receptors. This stops after a few months when our body realises what is occurring! Receptors possibly desensitise owing to an excess of testosterone and dopamine is also lowered due to how it is very tightly controlled, being the reward neurotransmitter.

As I mentioned in my last post, I think high levels of T affect the balance of sympathetic and parasympathetic neural activity in the erectile tissues. It is also possible that it affects the autonomic nervous system as a whole too. If adrenergic receptors in the penis become upregulated or more sensitive to noradrenalin, stimulation from the reflex or psychogenic centres will have a harder time instigating and maintaining an erection. The use of AAS may have also caused issues here.

It could also be for some men, that the loss of upstream hormones also cause issues with erectile function.

Testosterone can be great for mental libido, but sex drive in the loins can be quite absent when it is in excess and there is no LH and FSH in the system. Sexual function is comprised of all the hormones/neurotransmitters working in synergy with each other. Remove or interrupt some of them and it is logical to think sexual function will not work quite the same. The problem with TRT is that it changes a lot with our hormonal milieu. You do not expect a machine to work correctly or at all if you remove certain parts or processes. Our bodies are very clever and find other pathways to make do when things are missing or dysfunctional, but sometimes it just can’t and mechanisms fail.

Some men have very strong erectile function, that is, it is rarely affected by stress and other inhibiting factors, whilst others can have quite sensitive function that can be affected easily by emotional states, stress and chemicals such as caffeine, alcohol and amphetamines. Hormonal disturbance could play havoc with erectile function in some men for the same reasons. Penises come in many shapes and sizes as we know, the internal design and function will therefore also be quite varied as well, this is important to understand.

There is a possibility here that you do not need to be on testosterone replacement at all. Natural hormone function is always the best for young men. TRT is a difficult journey and rarely replicates sexual function in a young male comparable to how your body functions naturally when it is healthy. Perhaps your previous restarts need to be examined thoroughly as to their effectiveness and tried again.
 

Tn198989

Member
How long were you on AAS for? More than one cycle?

In your first post you have said you tried many times to recover with SERM’s, but it appears from what you have just said that you took Clomid almost constantly after that cycle until you started TRT? From what I could understand, you only had a month off all these drugs before you decided to take TRT? Was this all under a doctor’s care? Has a doctor been instructing you to increase your dose of T up to 200mgs per week?
It looks like you did not try and stop all medications and let your body find its own homeostasis for a period of 6 months or more after the trials on Clomid?

Did you do a very slow gradual taper of Clomid before you stopped the SERM therapy? This is quite important.
Perhaps you could describe exactly what you have done with these restarts, the time periods and when TRT was initiated.

It can sometimes take 6 months to a year for some guys to return to normal function after using AAS, depending on the amount of cycles they have done and the length of those cycles? Sexual function can be all over the place for some time after these restarts and anabolic steroid use.

Clomid, owing to its Zuclomiphene component does interfere with sexual function in some men. This isomer of Clomid also builds up in the body and can continue to cause sexual difficulties post DC of the drug. It can cause issues with erectile function and sexual sensation in the penis itself for some time. Enclomiphene citrate is supposed to eliminate some of these issues. These drugs have varied effects on different men. We all have our own unique biochemistry that can respond well or not so well with these chemicals, as it can with any drug we put into our system.

You also mention you have record of a test showing you had a level of T at 500 before steroid use. At this time you are almost double that on TRT. It is no wonder IMO that your sexual function is not working well.

I see you have constantly tried to replicate the “honeymoon period” by increasing dosages. Often the honey moon period happens because of the sudden surge in testosterone and its effects on dopamine and fresh androgen receptors. This stops after a few months when our body realises what is occurring! Receptors possibly desensitise owing to an excess of testosterone and dopamine is also lowered due to how it is very tightly controlled, being the reward neurotransmitter.

As I mentioned in my last post, I think high levels of T affect the balance of sympathetic and parasympathetic neural activity in the erectile tissues. It is also possible that it affects the autonomic nervous system as a whole too. If adrenergic receptors in the penis become upregulated or more sensitive to noradrenalin, stimulation from the reflex or psychogenic centres will have a harder time instigating and maintaining an erection. The use of AAS may have also caused issues here.

It could also be for some men, that the loss of upstream hormones also cause issues with erectile function.

Testosterone can be great for mental libido, but sex drive in the loins can be quite absent when it is in excess and there is no LH and FSH in the system. Sexual function is comprised of all the hormones/neurotransmitters working in synergy with each other. Remove or interrupt some of them and it is logical to think sexual function will not work quite the same. The problem with TRT is that it changes a lot with our hormonal milieu. You do not expect a machine to work correctly or at all if you remove certain parts or processes. Our bodies are very clever and find other pathways to make do when things are missing or dysfunctional, but sometimes it just can’t and mechanisms fail.

Some men have very strong erectile function, that is, it is rarely affected by stress and other inhibiting factors, whilst others can have quite sensitive function that can be affected easily by emotional states, stress and chemicals such as caffeine, alcohol and amphetamines. Hormonal disturbance could play havoc with erectile function in some men for the same reasons. Penises come in many shapes and sizes as we know, the internal design and function will therefore also be quite varied as well, this is important to understand.

There is a possibility here that you do not need to be on testosterone replacement at all. Natural hormone function is always the best for young men. TRT is a difficult journey and rarely replicates sexual function in a young male comparable to how your body functions naturally when it is healthy. Perhaps your previous restarts need to be examined thoroughly as to their effectiveness and tried again.
thanks for the detailed answer. I took breaks from clomid (for 2-3 months at a time) but yeah most of the time i was on it, although not consistently. I would wait 2-3 months, then run 2-3 weeks of either 25mg clomid or 10mg nolva. I did took a long break for about 4-5 months during this time.

I ve seen numerous doctors (more than 10 endo's) while trying to recover but where i live they dont know much about trt. The decision to hop on was due to the fact that i took proviron a month prior cause it was the only thing that helped with libido and supposedly it doesnt cause much suppression (bullshit). Before starting trt during 2019 if i remember correctly i also did 3 months of hcg only (no difference). I started trt on May 2021

During trt i use hcg for a month every now and the to keep testicle size. i know i might be able to restore natural production but the roller coaster and the probability of it not working is not something i can handle at the moment. Plus since starting everything has become better (besides erections), gym performance, confidence and also a big drop in blood sugar levels (from 105 to 85).

Although my trt is presribed by an endo i asked him for it. About the doses i took it in my own hands cause he didnt seem to know what he was doing (he suggested one injection 200mg every 3 weeks and he said that with this way you avoid the shutdown lol). I dont think my dose means much cause i was going with bloodwork 200mg puts me at 1050 total t which is high but not super high.

I would also like to add here that during the 2 cycles i have done i used to run 500 to 700mg of testosterone and my libido and erection were very high. Thats why i think that something is caused either by the long clomid runs or the time without morning erections that followed the last cycle (2018).

Truth is according to bloodwork ever since starting trt i never even got close to the 500nd/dl that i had prior to starting steroids. the lowest i ve seen my t on trough is 650 on 125mg per week. Maybe that is the best thing to do. Drop my dose to mimick my natural production although if e2 is managed i cant see how a lower t level within the normal range would be better for erections.
 

Simbarn

New Member
I will reply below your comments.

“thanks for the detailed answer. I took breaks from clomid (for 2-3 months at a time) but yeah most of the time i was on it, although not consistently. I would wait 2-3 months, then run 2-3 weeks of either 25mg clomid or 10mg nolva. I did took a long break for about 4-5 months during this time.”

I see, your other post says you did not take a break for longer than a month. “All this years from November 2018 until June 2021 when I started trt I didn't stop serms for more than a month”. Your story seems to change. I will go with what you have just said now. You have done all of the above SERM cycles on your own or with a doctors guidance? Your periods on Clomid being only 2-3 weeks are very short. You didn’t answer my question as to if you did long tapers at the end of these bouts with either Clomid or Nolvadex? It does not sound like it as you would have had to run these courses for much longer for that to happen. Suddenly DC these drugs can cause the higher level of gonadotropins they create to crash. Dr Crisler, who understood restarts very well always said a long slow taper is very important for them to have a good chance at working. Also, did you use HCG prior to the Clomid when you first started the SERM treatment? I do not see any mention of HCG during these restarts.

The testes are always the slowest to respond compared to the pituitary when doing a restart. Often restarts fail because of this. This is because the testes fully shut down with very high doses of T (which you were taking). They atrophy. The pituitary still produces other hormones, so it does not atrophy like the testes do. If the testes are up and running when LH and FSH are stimulated by Clomid, this can hasten the whole recovery process.
From what you have described it appears your restarts have been not done correctly.

“I ve seen numerous doctors (more than 10 endo's) while trying to recover but where i live they dont know much about trt. The decision to hop on was due to the fact that i took proviron a month prior cause it was the only thing that helped with libido and supposedly it doesnt cause much suppression (bullshit). Before starting trt during 2019 if i remember correctly i also did 3 months of hcg only (no difference). I started trt on May 2021”

You have seen 10 specialists in that period of time! Why have you seen so many Endocrinologists? Did most refuse to put you on testosterone?

“During trt i use hcg for a month every now and the to keep testicle size. i know i might be able to restore natural production but the roller coaster and the probability of it not working is not something i can handle at the moment. Plus since starting everything has become better (besides erections), gym performance, confidence and also a big drop in blood sugar levels (from 105 to 85).”

Are you pre-diabetic? How are you managing this?

Correct, that amount testosterone you are on will be great for stimulating muscle development. This does not mean it is good for you. I know of many guys that have said they wanted to be on TRT just for this reason. Confidence too will be boosted, as testosterone can work like a mood enhancing drug. This is one of its dangers. One reason AAS users keep going back on cycles. Some things have appeared to get better for you whilst on these high doses except for the one thing that is extremely important to any young male, sexual function.
I am going to be very to the point here: Your sexual function, namely your erectile function will never work properly no matter what you try and do, while you are taking that amount of testosterone that you are now on. In fact you are probably running the risk of causing morphological tissue changes in the erectile tissues earlier than would otherwise be occurring at 33 years of age. Raising T levels beyond what you are designed to have biochemically is not healthy and this is not just because it elevates estrogen.

I can see you like the effects of the high testosterone level, most probably due to how it improves your performance in the gym. This is not dissimilar to using it for AAS purposes. Your natural T level would not give you these results I would imagine, so you need to be honest with yourself as to why you are persistent with being on TRT or specifically wanting to stay on a high dose of T.

“Although my trt is presribed by an endo i asked him for it. About the doses i took it in my own hands cause he didnt seem to know what he was doing (he suggested one injection 200mg every 3 weeks and he said that with this way you avoid the shutdown lol). I dont think my dose means much cause i was going with bloodwork 200mg puts me at 1050 total t which is high but not super high.”

Your dose means everything. Doubling your natural level of T IMO to 1050 is very high for you. I understand your loss of confidence in this doctor if he said this about shutdown. This is very odd for an experienced Endo as they all know that shut down is inevitable.

I am nearly 60. My dose of injectable T is about 60-70mgs per week which I split into two doses. If I increase this dose, I notice that my ED issues increase markedly. I get a very good consistent response from 5 mgs of Tadalafil which I take daily. At my age and due to hormonal issues in my past I no doubt have changes in tissue content and function in my penis, whereby I need that boost in the NO pathway for better erectile function. You do not want to accelerate the need for this at your age and possibly end up requiring IC penis injections for sex later on.

From what you have said even Tadalafil is not giving you a strong normal erection. This is even more evidence IMO that your current HRT protocol is inhibiting erectile function to a great degree.
Our body produces T in a diurnal rhythm. It has two peaks in the day, morning being the highest. Why do you think we have those peaks and troughs? What do you think saturating your cells with what they see as an overdose of a particular chemical messenger does? Have a really good think about it. What happens when we overdose our cells with insulin, glucagon, cortisol, adrenalin… It isn’t good. Testosterone is not the exception.

“I would also like to add here that during the 2 cycles i have done i used to run 500 to 700mg of testosterone and my libido and erection were very high. Thats why i think that something is caused either by the long clomid runs or the time without morning erections that followed the last cycle (2018).”

When you use testosterone in AAS cycles the androgen receptor is usually fresh to its effects. It will then drive libido very high in most men and erections will also seem stronger. The HPTA is also still running for a brief period and the effects of not having LH and FSH will have not set in. Over time all this will change, and supra-physiological doses will eventually cause complete sexual dysfunction. I understand why you have come to this conclusion, but it is not correct.

“Truth is according to bloodwork ever since starting trt i never even got close to the 500nd/dl that i had prior to starting steroids. the lowest i ve seen my t on trough is 650 on 125mg per week. Maybe that is the best thing to do. Drop my dose to mimick my natural production although if e2 is managed i cant see how a lower t level within the normal range would be better for erections.”

I agree, you have not emulated your natural production at any time since being on TRT, this is bad HRT. You cannot see how a lower T level will be better for erections? This is because you have no knowledge of erectile function. Spend the next few years of your life learning about it, reading medical textbooks and collecting papers on erectile dysfunction from reputable researchers and you may then have some understanding of what you may be doing to yourself by self-medicating with excessive testosterone. I have tried to explain in the other posts some reasons why excessive T is not good for erectile function. It is not just about estrogen! Research is still discovering much about ED, hence why medicine still cannot cure many forms of ED. Hormone disruption is a major cause of it and the correct balance of hormones is without question, vital.

My advice is to find a doctor who understands restarts very well. You do not want a life on TRT if it is at all avoidable, especially as you are still young. As you were perfectly healthy before your mistake of using AAS, I would be trying everything you can to restore your natural testosterone. There is a plethora of information on this forum about restarts and members who know a lot about them.
 

Tn198989

Member
I will reply below your comments.

“thanks for the detailed answer. I took breaks from clomid (for 2-3 months at a time) but yeah most of the time i was on it, although not consistently. I would wait 2-3 months, then run 2-3 weeks of either 25mg clomid or 10mg nolva. I did took a long break for about 4-5 months during this time.”

I see, your other post says you did not take a break for longer than a month. “All this years from November 2018 until June 2021 when I started trt I didn't stop serms for more than a month”. Your story seems to change. I will go with what you have just said now. You have done all of the above SERM cycles on your own or with a doctors guidance? Your periods on Clomid being only 2-3 weeks are very short. You didn’t answer my question as to if you did long tapers at the end of these bouts with either Clomid or Nolvadex? It does not sound like it as you would have had to run these courses for much longer for that to happen. Suddenly DC these drugs can cause the higher level of gonadotropins they create to crash. Dr Crisler, who understood restarts very well always said a long slow taper is very important for them to have a good chance at working. Also, did you use HCG prior to the Clomid when you first started the SERM treatment? I do not see any mention of HCG during these restarts.

The testes are always the slowest to respond compared to the pituitary when doing a restart. Often restarts fail because of this. This is because the testes fully shut down with very high doses of T (which you were taking). They atrophy. The pituitary still produces other hormones, so it does not atrophy like the testes do. If the testes are up and running when LH and FSH are stimulated by Clomid, this can hasten the whole recovery process.
From what you have described it appears your restarts have been not done correctly.

“I ve seen numerous doctors (more than 10 endo's) while trying to recover but where i live they dont know much about trt. The decision to hop on was due to the fact that i took proviron a month prior cause it was the only thing that helped with libido and supposedly it doesnt cause much suppression (bullshit). Before starting trt during 2019 if i remember correctly i also did 3 months of hcg only (no difference). I started trt on May 2021”

You have seen 10 specialists in that period of time! Why have you seen so many Endocrinologists? Did most refuse to put you on testosterone?

“During trt i use hcg for a month every now and the to keep testicle size. i know i might be able to restore natural production but the roller coaster and the probability of it not working is not something i can handle at the moment. Plus since starting everything has become better (besides erections), gym performance, confidence and also a big drop in blood sugar levels (from 105 to 85).”

Are you pre-diabetic? How are you managing this?

Correct, that amount testosterone you are on will be great for stimulating muscle development. This does not mean it is good for you. I know of many guys that have said they wanted to be on TRT just for this reason. Confidence too will be boosted, as testosterone can work like a mood enhancing drug. This is one of its dangers. One reason AAS users keep going back on cycles. Some things have appeared to get better for you whilst on these high doses except for the one thing that is extremely important to any young male, sexual function.
I am going to be very to the point here: Your sexual function, namely your erectile function will never work properly no matter what you try and do, while you are taking that amount of testosterone that you are now on. In fact you are probably running the risk of causing morphological tissue changes in the erectile tissues earlier than would otherwise be occurring at 33 years of age. Raising T levels beyond what you are designed to have biochemically is not healthy and this is not just because it elevates estrogen.

I can see you like the effects of the high testosterone level, most probably due to how it improves your performance in the gym. This is not dissimilar to using it for AAS purposes. Your natural T level would not give you these results I would imagine, so you need to be honest with yourself as to why you are persistent with being on TRT or specifically wanting to stay on a high dose of T.

“Although my trt is presribed by an endo i asked him for it. About the doses i took it in my own hands cause he didnt seem to know what he was doing (he suggested one injection 200mg every 3 weeks and he said that with this way you avoid the shutdown lol). I dont think my dose means much cause i was going with bloodwork 200mg puts me at 1050 total t which is high but not super high.”

Your dose means everything. Doubling your natural level of T IMO to 1050 is very high for you. I understand your loss of confidence in this doctor if he said this about shutdown. This is very odd for an experienced Endo as they all know that shut down is inevitable.

I am nearly 60. My dose of injectable T is about 60-70mgs per week which I split into two doses. If I increase this dose, I notice that my ED issues increase markedly. I get a very good consistent response from 5 mgs of Tadalafil which I take daily. At my age and due to hormonal issues in my past I no doubt have changes in tissue content and function in my penis, whereby I need that boost in the NO pathway for better erectile function. You do not want to accelerate the need for this at your age and possibly end up requiring IC penis injections for sex later on.

From what you have said even Tadalafil is not giving you a strong normal erection. This is even more evidence IMO that your current HRT protocol is inhibiting erectile function to a great degree.
Our body produces T in a diurnal rhythm. It has two peaks in the day, morning being the highest. Why do you think we have those peaks and troughs? What do you think saturating your cells with what they see as an overdose of a particular chemical messenger does? Have a really good think about it. What happens when we overdose our cells with insulin, glucagon, cortisol, adrenalin… It isn’t good. Testosterone is not the exception.

“I would also like to add here that during the 2 cycles i have done i used to run 500 to 700mg of testosterone and my libido and erection were very high. Thats why i think that something is caused either by the long clomid runs or the time without morning erections that followed the last cycle (2018).”

When you use testosterone in AAS cycles the androgen receptor is usually fresh to its effects. It will then drive libido very high in most men and erections will also seem stronger. The HPTA is also still running for a brief period and the effects of not having LH and FSH will have not set in. Over time all this will change, and supra-physiological doses will eventually cause complete sexual dysfunction. I understand why you have come to this conclusion, but it is not correct.

“Truth is according to bloodwork ever since starting trt i never even got close to the 500nd/dl that i had prior to starting steroids. the lowest i ve seen my t on trough is 650 on 125mg per week. Maybe that is the best thing to do. Drop my dose to mimick my natural production although if e2 is managed i cant see how a lower t level within the normal range would be better for erections.”

I agree, you have not emulated your natural production at any time since being on TRT, this is bad HRT. You cannot see how a lower T level will be better for erections? This is because you have no knowledge of erectile function. Spend the next few years of your life learning about it, reading medical textbooks and collecting papers on erectile dysfunction from reputable researchers and you may then have some understanding of what you may be doing to yourself by self-medicating with excessive testosterone. I have tried to explain in the other posts some reasons why excessive T is not good for erectile function. It is not just about estrogen! Research is still discovering much about ED, hence why medicine still cannot cure many forms of ED. Hormone disruption is a major cause of it and the correct balance of hormones is without question, vital.

My advice is to find a doctor who understands restarts very well. You do not want a life on TRT if it is at all avoidable, especially as you are still young. As you were perfectly healthy before your mistake of using AAS, I would be trying everything you can to restore your natural testosterone. There is a plethora of information on this forum about restarts and members who know a lot about them.
Hello there,

I had to look up what times I took serms and for how long that's why my story changed a bit. Anyway, I understand how a taper works but shouldn't it be reflected on blood work? I always took blood work 6 weeks after every restart attempt. I didn't do a long taper but for the last weeks I always dropped the dose a lot. Also I didn't do them without doctors guidance. The problem is that even with doctors guidance I saw no benefit.

I did use hcg for 2 weeks prior to the first 2 restart attempts. But why do all these things matter. If 6-8 weeks after a pct attempt your lh and fsh along with total t are good and remain so isn't the restart successful?? My problem is that although everything looked good on blood work the sexual function never recovered. If the restart wasn't successful then the lh wouldn't increase (secondary) or if it did, it wouldn't increase testosterone (primary).

The reason I saw so many endocrinologist wasn't because they didn't give me trt. I didn't want trt. I wanted to recover. I saw so many cause they didn't seem to know what they were doing. Some of them dismissed the issue as non hormonal since my blood work was ok. And when I mean ok I don't mean bordeline ok. My lh was around 7-8 total t fluctuated from 600 to 900, e2 sometimes around 30 sometimes higher. Believe me it wasn't an easy choice to hop on trt. That's why I delayed it 3 years while I was struggling.

I guess I was pre diabetic although my blood sugar wasn't always above 100 but sometimes it rose to 105. I don't need to manage it. Ever since I got on trt it has lowered to below 90 and stayed that way for more than a year.

I am already dropping the dose although I look more to what level of t it brings me, not the dose. I am now on 180 split in 3 doses and I ll go lower but after I get blood work.

I already accepted life on trt and if I fix the erectile function I won't quit.

If I can't fix it while on t then I ll consider stopping it.

But for now I am not looking for yet another restart.

Could you please post a link to a paper that shows that high t is bad for erections despite normal e2 or any other hormone?

Lastly, in your opinion could an enlarged prostate cause these issues? ( it was the one thing I never tested, only psa which came back normal) and if it does cause something like blood flow issue, wouldn't it get picked up on the doppler?

Thanks in advance
 
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Simbarn

New Member
Just curious, if I may ask, what form of injectable and concentration? And, what days do you take it?
I use Enanthate, which comes in a one ml solution at 250mg. I inject on Wednesday and Saturday mornings. Its called Primoteston in Australia where I am from. I need to transfer to a multi-dose vial as this preparation comes in a single use syringe.
I use a 27g needle into the thigh, which I hyper-inject as the fat layer is very thin in this area on me. I find using these these fine needles much easier than using the standard gauges for intramuscular such as 23g. I've had no issues with hematoma doing this.
I tried subq into the abdomen and it didn't agree with me.
 

Simbarn

New Member
Hello there,

I had to look up what times I took serms and for how long that's why my story changed a bit. Anyway, I understand how a taper works but shouldn't it be reflected on blood work? I always took blood work 6 weeks after every restart attempt. I didn't do a long taper but for the last weeks I always dropped the dose a lot. Also I didn't do them without doctors guidance. The problem is that even with doctors guidance I saw no benefit.

I did use hcg for 2 weeks prior to the first 2 restart attempts. But why do all these things matter. If 6-8 weeks after a pct attempt your lh and fsh along with total t are good and remain so isn't the restart successful?? My problem is that although everything looked good on blood work the sexual function never recovered. If the restart wasn't successful then the lh wouldn't increase (secondary) or if it did, it wouldn't increase testosterone (primary).

The reason I saw so many endocrinologist wasn't because they didn't give me trt. I didn't want trt. I wanted to recover. I saw so many cause they didn't seem to know what they were doing. Some of them dismissed the issue as non hormonal since my blood work was ok. And when I mean ok I don't mean bordeline ok. My lh was around 7-8 total t fluctuated from 600 to 900, e2 sometimes around 30 sometimes higher. Believe me it wasn't an easy choice to hop on trt. That's why I delayed it 3 years while I was struggling.

I guess I was pre diabetic although my blood sugar wasn't always above 100 but sometimes it rose to 105. I don't need to manage it. Ever since I got on trt it has lowered to below 90 and stayed that way for more than a year.

I am already dropping the dose although I look more to what level of t it brings me, not the dose. I am now on 180 split in 3 doses and I ll go lower but after I get blood work.

I already accepted life on trt and if I fix the erectile function I won't quit.

If I can't fix it while on t then I ll consider stopping it.

But for now I am not looking for yet another restart.

Could you please post a link to a paper that shows that high t is bad for erections despite normal e2 or any other hormone?

Lastly, in your opinion could an enlarged prostate cause these issues? ( it was the one thing I never tested, only psa which came back normal) and if it does cause something like blood flow issue, wouldn't it get picked up on the doppler?

Thanks in advance
Ok, you have provided a little more insight into your issue.
You did use HCG in your restart attempts. The more accurate information you provide does help a great deal for anyone here on this forum trying to help you.
The tapers are very important when doing a restart. You mentioned earlier you only took Clomid for 2-3 weeks per time, which does not leave any time for a reasonable taper off.

I am a little confused at this point. Did your total testosterone, plus your LH and FSH recover to an acceptable level after discontinuing Clomid and stay that way?
From what you have just said, some of the Endocrinologists that you saw determined that your hormones were recovered and given that, you did not require hormone replacement?
You have also said that it was not just borderline ok, but quite above this, correct?
Your main complaint was sexual function, not low hormone levels, correct?

So it appears to me you recovered your natural hormone function quite well, but kept doing cycles of Clomid to try and reinstate sexual function?
Clomid only works to recover your production of gonadotropins, if it does this, it has done its job. No point in continuing it to try and fix sexual dysfunction, when part of this dysfunction maybe caused by the Clomid itself.

Clomid will interfere with sexual function in many men. It will continue to do this for some time afterward also. I talked about this earlier on.

If your hormone levels did return to normal, do you really think you should be on TRT? Your body may need some time to firstly clear the residual Clomid out of your body and then many months to find homeostasis again.
Sexual function may take a long time to return, especially after all these episodes on Clomid and the initial trauma caused by AAS use.

How long was the longest period you left your body alone to recover after stopping all these drugs? In earlier posts of yours you mention only one month, later ones a couple of months.

I already accepted life on trt and if I fix the erectile function I won't quit.
If your endogenous hormones were at acceptable levels, why would your doctor put you onto TRT?
If your Testosterone was at a good level before you started TRT, undertaking T replacement will not fix your erectile dysfunction, in fact quite the opposite. This is well understood.

The unfortunate thing about all of this is that you have shut all your hormones down again after the apparent full recovery. This is not good. I am not including erectile function here in that recovery as this can be a very separate issue.

It is the culmination of many years of learning about ED and reading many papers that has given me all the information I need to understand that high T is not good. It is not one specific paper that has determined this in the human.
Some have discussed tissue changes in the rat model. Many discuss how hormones alter neurotransmission, the autonomic nervous system and sympathetic activity in the penis.
It is very difficult to do any trials on human subjects as we cannot subject them to high levels of androgens and then sacrifice their penises for examination at a histological level! Even getting subjects willing to do a biopsy would be extremely difficult.
Hence why much of this is done with rabbits and rats.
If you are interested you should start researching yourself, especially if you are determined to stay on TRT.

If you had an enlarged prostate, which I doubt at 33, you would most likely be experiencing changes in your ability to urinate. From what I understand ED and PE are separate issues. It is more the drugs used to treat PE that can contribute to ED.
Research has shown a connection with an increase in adrenergic receptor expression/activity in the tissues of both organs however, as men age. This does not mean one causes the other.

As you may be pre-diabetic, meaning you were becoming insulin resistant, this in itself can cause many issues in the body. Diabetes 2 is a high risk factor for erectile dysfunction. I do not think managing insulin resistance with high levels of Testosterone is appropriate.

What do you think is possibly wrong with your diet and lifestyle that has caused your insulin resistance?
 
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