Who Started TRT w/ "Normal" Levels @ What Age?

[Fortunate]

My opinion is that TRT is reasonable if you have no other way of addressing your problems. It looks like you are already making lifestyle changes. Are there any more changes you can make? For example:

• are you taking any medication that can reduce testosterone (opioids, etc)?
• how is your sleep hygiene?
• is stress under control?
  • ever consider learning meditation?
• is body fat under control?
• can you tweak your diet?

I commend you for recognizing your porn addiction and your willingness to share it. I suspect that may be playing a role in your libido. I recommend being patient, keep working with your therapist and let the process work itself out.

I have been on TRT for about 7 years. My struggle to find the sweet spot is pretty well documented around here. I sometimes look back and wonder if I would require TRT had I made more concerted efforts to control modifiable lifestyle factors. On the other hand, I have zero problem with TRT if I need it.

I would make efforts on lifestyle. If you end up in the same place, contemplating TRT, no problem. At least you won't have the nagging questions I have when I wonder what would have been had I done the same.

 

[JYD21]

My opinion is that TRT is reasonable if you have no other way of addressing your problems. It looks like you are already making lifestyle changes. Are there any more changes you can make? For example:

• are you taking any medication that can reduce testosterone (opioids, etc)?
• how is your sleep hygiene?
• is stress under control?
  • ever consider learning meditation?
• is body fat under control?
• can you tweak your diet?

I commend you for recognizing your porn addiction and your willingness to share it. I suspect that may be playing a role in your libido. I recommend being patient, keep working with your therapist and let the process work itself out.

I have been on TRT for about 7 years. My struggle to find the sweet spot is pretty well documented around here. I sometimes look back and wonder if I would require TRT had I made more concerted efforts to control modifiable lifestyle factors. On the other hand, I have zero problem with TRT if I need it.

I would make efforts on lifestyle. If you end up in the same place, contemplating TRT, no problem. At least you won't have the nagging questions I have when I wonder what would have been had I done the same.

Sleep has been ok. No meds. Just OTC stuff like C, D3/K2, Boron, occasionally maca and Tongat Ali, zinc, magnesium, etc, etc.

I'm probably 18%BF. I could maybe work on that, but to most, I'm considered athletic & well built.

I just moved homes. Doing more contract work vs. FTE, so that's kind of stressful. The last 1.5 years have been difficult (lost job, going contract, less cash, etc).

Diet & exercise is pretty on point, though.

Done with the porn. It was intermittent.

I'm a lifelong bachelor, enjoyed single life a lot my entire adulthood, so being in a committed monogamous relationship (4.5 years now) can be difficult for me, but I'm challenging myself & my assumptions in new ways.

I think part of it is the mental mid-life part of no longer being 21 (or 31) anymore and a lot of uncertainty around my job. I'm wanting 'instant gratification' to some degree, so I know that's not a reason to jump on it.

I'm doing all the right things now, so.

THanks for your insight.

 

[Esq]

At least in the clinical trials enclomiphene modestly increased estradiol. But it's true that the blocking of certain estrogen receptors may do both good and bad things, depending on the individual and the dose. The criticism of enclomiphene is that you can have great looking numbers but poor subjective results. Given this unpredictability I do recommend the nasal gel as a first choice.

How does enclomiphene monotherapy compare with clomiphene monotherapy? I was about to type up my own experience with clomiphene monotherapy when I noticed that enclomiphene was being discussed. I remember vaguely enclomiphene being discussed on here back when I was on clomiphene (2017), but my recollection is that it was very new at that time.

To OP's question, I started TRT in late 2017 at age 36. My levels weren't terrible (total T of 550 and free T of 15), but I felt terrible and and nothing else helped, including lifestyle changes, being treated for sleep apnea, and clomiphene monotherapy. It has changed my life for the better without a doubt. I have absolutely no regrets whatsoever, but luckily I was able to get my hormone levels balanced pretty quickly and my regimen has stayed relatively consistent over the years for the most part. I also haven't (yet) experienced any of the more serious side effects like elevated hematocrit, elevated blood pressure, hair loss, etc. It also has done wonders for my libido, as it has for my wife (also a Defy patient).

I do recommend that you try to rule everything else out before taking the plunge. At my age and with my levels, Dr. Saya was clear with me that it was a last resort. He tried a lot of things, including the aforementioned clomiphene, cortisol testing (multiple times), and other less invasive options. We worked together for almost a full year before I started TRT.

I don't see it listed in your posts, but if you suffer from fatigue or tiredness issues I recommend that you consider being tested for sleep apnea. That also can cause sexual dysfunction and libido issues. It so frequently goes undiagnosed, especially in people who are otherwise healthy. I'm lean, fairly muscular, and young, and still suffer from it, as does my very fit 39 year-old wife. It is not the fat-old-man's disease many perceive it to be.

 

[Cataceous]

How does enclomiphene monotherapy compare with clomiphene monotherapy? ...

There are still relatively few guys on enclomiphene monotherapy, making it difficult to judge. My expectation is that results with enclomiphene should on average be somewhat better than with clomiphene. The reasoning is that clomiphene is essentially enclomiphene plus estrogen (zuclomiphene). While some guys need more estrogenic activity, I expect that most do not. Of course without more concrete information it's easy to put forth a completely different hypothesis. For example: Enclomiphene is such a strong estrogen blocker that it's actually useful to temper it with zuclomiphene.

I find it bothersome that there's still a lot to be understood about these drugs. Even within a single organ there appear to be contradictory effects. Enclomiphene doesn't affect SHBG, but clomiphene typically raises SHBG substantially, presumably due to the estrogenic effects of zuclomiphene in the liver. On the other hand, both clomiphene and enclomiphene reduce IGF-1, which is also produced primarily in the liver.

 

[UK_TRT_Guy]

Different organisations use different ranges so it will depend on which one you use to get a range that may suit your readings. However, keep in mind that just because it's in range today doesn't mean that it will be in range in 6 to 12 months, especially if you're at the lower end. I started TRT when I was 42 and am now 46 and haven't looked back, best decision I ever made. Hope you get the answers/help you need!

 

[JimGainz]

I was late 40s with a total testosterone of 425 ng/dl and a free T of 6.9. With your levels, I would recommend waiting a bit if possible. I tried the Clomid route and it jacked my Testosterone up to 900 and then a month later I was back to 425 again.

 

[JYD21]

How does enclomiphene monotherapy compare with clomiphene monotherapy? I was about to type up my own experience with clomiphene monotherapy when I noticed that enclomiphene was being discussed. I remember vaguely enclomiphene being discussed on here back when I was on clomiphene (2017), but my recollection is that it was very new at that time.

To OP's question, I started TRT in late 2017 at age 36. My levels weren't terrible (total T of 550 and free T of 15), but I felt terrible and and nothing else helped, including lifestyle changes, being treated for sleep apnea, and clomiphene monotherapy. It has changed my life for the better without a doubt. I have absolutely no regrets whatsoever, but luckily I was able to get my hormone levels balanced pretty quickly and my regimen has stayed relatively consistent over the years for the most part. I also haven't (yet) experienced any of the more serious side effects like elevated hematocrit, elevated blood pressure, hair loss, etc. It also has done wonders for my libido, as it has for my wife (also a Defy patient).

I do recommend that you try to rule everything else out before taking the plunge. At my age and with my levels, Dr. Saya was clear with me that it was a last resort. He tried a lot of things, including the aforementioned clomiphene, cortisol testing (multiple times), and other less invasive options. We worked together for almost a full year before I started TRT.

I don't see it listed in your posts, but if you suffer from fatigue or tiredness issues I recommend that you consider being tested for sleep apnea. That also can cause sexual dysfunction and libido issues. It so frequently goes undiagnosed, especially in people who are otherwise healthy. I'm lean, fairly muscular, and young, and still suffer from it, as does my very fit 39 year-old wife. It is not the fat-old-man's disease many perceive it to be.

Great post! ...I never really thought apnea could be a factor, but it may be something I look into. ...I agree to try everything before taking the plunge. I'm working with a functional medicine doc that focuses on hormone optimization along with nutrition & lifestyle. He said we may try some other things first, as well.

I mentioned enclomiphene & he said that could be an option, but we need to take bloodwork in March first, including saliva cortisol to see what that's doing. But I don't want something that takes my low-normal E2 & crushes it lower.

I was late 40s with a total testosterone of 425 ng/dl and a free T of 6.9. With your levels, I would recommend waiting a bit if possible. I tried the Clomid route and it jacked my Testosterone up to 900 and then a month later I was back to 425 again.

So what are you doing today? And what was your overall experience on Clomid?

Cheers.

 

[JimGainz]

Great post! ...I never really thought apnea could be a factor, but it may be something I look into. ...I agree to try everything before taking the plunge. I'm working with a functional medicine doc that focuses on hormone optimization along with nutrition & lifestyle. He said we may try some other things first, as well.

I mentioned enclomiphene & he said that could be an option, but we need to take bloodwork in March first, including saliva cortisol to see what that's doing. But I don't want something that takes my low-normal E2 & crushes it lower.


So what are you doing today? And what was your overall experience on Clomid?

Cheers

I ran Clomid at 12.5 mg per day. Wasn’t bad but once I came off my T tanked. I never felt great on it - couldn’t sleep and made me a little edgy.

When I came off I started on gels and HCG but my levels were too variable (common with gels). I wound up switching to shots - first weekly, then 2x weekly, then E3days and now every day (10 mg daily with nandrolone).

 

[Esq]

I ran Clomid at 12.5 mg per day. Wasn’t bad but once I came off my T tanked. I never felt great on it - couldn’t sleep and made me a little edgy.

When I came off I started on gels and HCG but my levels were too variable (common with gels). I wound up switching to shots - first weekly, then no weekly, then E3days and now every day (10 mg daily with nandrolone).

I had the same issues with Clomid, and my estradiol went through the roof. I was very irritable and emotional on it. Not sure if that was because of the high estradiol, but I never felt good on it even though my testosterone levels skyrocketed.

 

[aneuman]

Guys, great posts, very helpful. A bit go history and then kindly seeking advice.

Background
========
I'm an older guy, 59. Always had extremely high libido and rock hard erections until my mid to late 40s, when things started to go down a little. Went to the doctor, Testosterone was 283 ng/dl in 2019 and doctor said I was okay. Prescribed Cialis 5 mg daily, which worked well in general and also helped me with my BPH. Libido and quality or orgasm was good. I started working out, taking supplements, improving diet, losing weight (from 190 to 175, I'm 6 feet tall) and 6 months later my TT was 403 ng/dL

Then about 2 years ago, I started having problems with delayed ejaculation (sometimes more than 30-40 min) and quality or orgasm was really bad, basically no sensations during the whole trip just to feel the orgasm coming and going in a sec.

Went to andrologist (quite famous) about a year ago. I was feeling like crap, but still had some libido, I still had thoughts about sex (which I have always had), required a lot of work to get an erection but once I got it it would remain up for a long time, but orgasms were crappy.

My initial tests before starting treatment were:

Total Testosterone =492 ng/dL
Estradiol: 27 pg/ml.
LH: 2.6 mIU/ml
FSH: 7.1 mIU/ml

HCG Monotherapy
===========
He prescribed HCG (from Empower) 2000 UI every week starting August 2020. For the first 3 weeks I was over the moon. I felt like 40, lots of optimism, days were beautiful, the mere thinking of sex got me an erection, my penis was very sensible, morning erections returned, did not have to use Cialis, orgasms were great, I could focus on sex and enjoy every minute of it. On top of that, all my BPH symptoms went away, I could urinate fully and stronger. My balls were bigger, my penis felt fuller. Had not felt that way for decades! Full of confidence. But it all went downhill after the first 3 or 4 weeks. I started feeling worse than when I started the treatment, erection was worse, BPH symptoms returned, orgasm was even more delayed, sometimes impossible, no sex thoughts, no interest in sex.
After 3 months on HCG 2000UI every week, my tests came back as:

Total testosterone: 309 nd/dl,
LH: 5.7 mUI/ml
FSH: 5.5 mIU/ml
estradiol: 27 pg/mL.

Enclomiphene Citrate
=============
After these disappointing results (which coincided with the fact that Empower would not sellHCG anymore) my doctor switched me to enclomiphene citrate from Empower at 12.5 mg every day. I've been taking it for almost 3 months and I decided to do my own tests since the doctor did not prescribe any follow up, and these are the results

TT: 710 ng/dL
FT: 126 pg.mL
FSH: 15.2 mIU/mL
LH: 19.7 mIU/mL
DHT: 57 ng/dL
E2: 32 pg/mL
DHEA: 230 mcg/dL

With these values I should be feeling great! But I don't I feel the worst I have ever felt. I have no libido, no interest in sex, no penile sensitivity, no morning erections, no sexual thoughts, naked women don't arouse me, and orgasms are really bad and take a long time and effort, not enjoyable.

Since you guys seem to know a lot about this stuff, could any of you suggest any route to get out of this rut? Im not enjoying life much in this situation, Sex has always been a very important thing to me.

By the way, I am not depressed or anything, at least not any more than probably 90% of the people in the world that had to go through 2 years of covid, now a war in Ukraine, etc. Fortunately, financially I seem to be okay. I'm happily married with a woman I like and love.

Do you think TRT would be a better option? If so, Natesto?, Androgel? Testosterone Cypionate? I'm not interested in bodybuilding or anything, just to recover a decent libido and decent enjoyment of sex with my wife.

I'm currently 59 years old, 6 feet tall, 180 lbs, about 20% body fat, work out every day (either walking 2 to 5 miles or rowing), eat mostly healthy (all home cooked food, no fast food) supplement with D3/K2, Magnesium, Zinc, B-Complex, Omega 3. Take Cialis 5 mg for BPH.

Thank you ver much

A.N

 

[JYD21]

Guys, great posts, very helpful. A bit go history and then kindly seeking advice.

Background
========
I'm an older guy, 59. Always had extremely high libido and rock hard erections until my mid to late 40s, when things started to go down a little. Went to the doctor, Testosterone was 283 ng/dl in 2019 and doctor said I was okay. Prescribed Cialis 5 mg daily, which worked well in general and also helped me with my BPH. Libido and quality or orgasm was good. I started working out, taking supplements, improving diet, losing weight (from 190 to 175, I'm 6 feet tall) and 6 months later my TT was 403 ng/dL

Then about 2 years ago, I started having problems with delayed ejaculation (sometimes more than 30-40 min) and quality or orgasm was really bad, basically no sensations during the whole trip just to feel the orgasm coming and going in a sec.

Went to andrologist (quite famous) about a year ago. I was feeling like crap, but still had some libido, I still had thoughts about sex (which I have always had), required a lot of work to get an erection but once I got it it would remain up for a long time, but orgasms were crappy.

My initial tests before starting treatment were:

Total Testosterone =492 ng/dL
Estradiol: 27 pg/ml.
LH: 2.6 mIU/ml
FSH: 7.1 mIU/ml

HCG Monotherapy
===========
He prescribed HCG (from Empower) 2000 UI every week starting August 2020. For the first 3 weeks I was over the moon. I felt like 40, lots of optimism, days were beautiful, the mere thinking of sex got me an erection, my penis was very sensible, morning erections returned, did not have to use Cialis, orgasms were great, I could focus on sex and enjoy every minute of it. On top of that, all my BPH symptoms went away, I could urinate fully and stronger. My balls were bigger, my penis felt fuller. Had not felt that way for decades! Full of confidence. But it all went downhill after the first 3 or 4 weeks. I started feeling worse than when I started the treatment, erection was worse, BPH symptoms returned, orgasm was even more delayed, sometimes impossible, no sex thoughts, no interest in sex.
After 3 months on HCG 2000UI every week, my tests came back as:

Total testosterone: 309 nd/dl,
LH: 5.7 mUI/ml
FSH: 5.5 mIU/ml
estradiol: 27 pg/mL.

Enclomiphene Citrate
=============
After these disappointing results (which coincided with the fact that Empower would not sellHCG anymore) my doctor switched me to enclomiphene citrate from Empower at 12.5 mg every day. I've been taking it for almost 3 months and I decided to do my own tests since the doctor did not prescribe any follow up, and these are the results

TT: 710 ng/dL
FT: 126 pg.mL
FSH: 15.2 mIU/mL
LH: 19.7 mIU/mL
DHT: 57 ng/dL
E2: 32 pg/mL
DHEA: 230 mcg/dL

With these values I should be feeling great! But I don't I feel the worst I have ever felt. I have no libido, no interest in sex, no penile sensitivity, no morning erections, no sexual thoughts, naked women don't arouse me, and orgasms are really bad and take a long time and effort, not enjoyable.

Since you guys seem to know a lot about this stuff, could any of you suggest any route to get out of this rut? Im not enjoying life much in this situation, Sex has always been a very important thing to me.

By the way, I am not depressed or anything, at least not any more than probably 90% of the people in the world that had to go through 2 years of covid, now a war in Ukraine, etc. Fortunately, financially I seem to be okay. I'm happily married with a woman I like and love.

Do you think TRT would be a better option? If so, Natesto?, Androgel? Testosterone Cypionate? I'm not interested in bodybuilding or anything, just to recover a decent libido and decent enjoyment of sex with my wife.

I'm currently 59 years old, 6 feet tall, 180 lbs, about 20% body fat, work out every day (either walking 2 to 5 miles or rowing), eat mostly healthy (all home cooked food, no fast food) supplement with D3/K2, Magnesium, Zinc, B-Complex, Omega 3. Take Cialis 5 mg for BPH.

Thank you ver much

A.N

I"m sorry to hear you're struggling, but glad you posted. I'm keen to follow your journey & see how you can get back on track and many of the folks here are very knowledgeable & should be able to guide you accordingly.

Hang in there.

 

[Systemlord]

With these values I should be feeling great! But I don't I feel the worst I have ever felt.

This response is common on clomid and enclomiphene and HCG isn't a good treatment for low-T.

Most of the time these options are for those on TRT who are looking to restore fertility.

You need testosterone, you need TRT which is much more effective than the other two options at treating low-T.

 

[Systemlord]

Do you think TRT would be a better option? If so, Natesto?, Androgel? Testosterone Cypionate?

As for injections cypionate is preferred, creams and Jatenzo (oral T) are other options. AndroGel isn't very effective in a lot of cases.

As for Natesto, it's not very practical, but has the advantage for not disrupting upstream hormones in the way other formulations of TRT do.

 

[aneuman]

As for injections cypionate is preferred, creams and Jatenzo (oral T) are other options.

As for Natesto it's not very practical.

Thanks Systemlord!

I have an appointment in 2 months with my andrologist. I suspect he will try something like Natesto, not sure why, but I guess this is where he's going based on other comments he's made.

One question, is it possible to take Cypionate sub-cutaneous (SQ)? I had to inject myself HCG and that was not a problem, I'm not sure about IM injections so frequently. What is the protocol, every week, every 2 weeks, every day?

Also, how about the gels, are they not as effective as Cypionate?

I'd love to hear you all comment on this. This has been a long journey for me for which there seems to be no good exit, as a matter of fact, things are worse today than when I first sought help.

Thanks again

A.N.

 

[Systemlord]

One question, is it possible to take Cypionate sub-cutaneous (SQ)?

Yes, but if it doesn't work out you can still use 27-29 gauge insulin syringes and inject shallow IM in the deltoids and quads.

The insulin syringes have the advantage of no dead space, so medicine isn't wasted.

What is the protocol, every week, every 2 weeks, every day?

You should inject at a minimum once weekly, some guys feel a dip in levels around 4-5 days and need two or more injections a week.

The every 2 week protocols are barbaric, sure there are men on them and doing well, but most with have issues.

These every 2 week protocols can shoot your T levels supraphysiological at peak and put you in the hypogonadal ranges by the second week and over time can cause issues with hematocrit.

 

[aneuman]

Yes, but if it doesn't work out you can still use 27-29 gauge insulin syringes and inject shallow IM in the deltoids and quads.

The insulin syringes have the advantage of no dead space, so medicine isn't wasted.


You should inject at a minimum once weekly, some guys feel a dip in levels around 4-5 days and need two or more injections a week.

The every 2 week protocols are barbaric, sure there are men on them and doing well, but most with have issues.

These every 2 week protocols can shoot your T levels supraphysiological at peak and put you in the hypogonadal ranges by the second week and over time can cause issues with hematocrit.

Thank you so much!

I think this is what I'll discuss with my doctor in April. Testosterone Cypionate Sub-Q every week. I assume he can calculate the amount of mg based on whatever, weight, age, target levels, etc.

Does it make sense?

I'm also curious about Jatenzo. Is it safe, affordable, covered by insurance? Have you taken it? What was your experience. My biggest issue as I said is not putting on muscles, having babies, or act in porn movies. I simply want to feel less shitty, sleep better, and have better libido and enjoy sex with my wife.

Also, is Cypionate expensive? HCG ran about $100/mo and Enclomiphene $50/mo (just as a reference)

Again, thank you for all this great info. Sometimes I feel that doctors, even when they are recognized as "one of the leaders in the field, professors or urology, researchers, etc" during their medical practices act more like applying a recipe than really evaluating each case on its own merit.

Thanks again!

A.N.

 

[Systemlord]

I'm also curious about Jatenzo. Is it safe, affordable, covered by insurance? Have you taken it? What is your experience.

It is covered by my insurance due to treatment failure for 4 years on injections and topicals and is safe according to the clinical trials and is FDA approved.

Jatenzo is expensive costing thousands per month and for this reason it needs to be covered by insurance.

I'm currently the only forum member that is on Jatenzo and I'm on the recommended starting dosage of 237 mg twice-daily.

My copay is $4.

My Experience On Jatenzo (Oral TRT) Log

I wanted to start a thread detailing my personal experience with Jatenzo (oral TRT) which is remarkable in how quickly it has shown results when compared with injections. The first week on Jatenzo was very pleasant unlike my experience after dosing changes on injections, all with minimal swings...

www.excelmale.com

 

[Systemlord]

Sometimes I feel that doctors, even when they are recognized as "one of the leaders in the field, professors or urology, researchers, etc" during their medical practices act more like applying a recipe than really evaluating each case on its own merit.

The doctors you would think to be the experts in this field of medicine sadly are not. A lot of doctors don't want anything to do with steroids, the politics and stigma attached to it.

Add to the fact that sex hormones aren't taught in traditional medical schools, therefore a lot of these doctors are operating on a complete lack of knowledge.

 

[aneuman]

Hey guys,

Wanted to give you an update, and obviously, I also have questions.

After about 3 months of Enclomiphene Citrate monotherapy (12.5 mg once daily) my labs came out amazing (I think, at lest for a 60 years old man)

Total Testosterone: 787 ng/dL. (Reference Range: 250-827 ng/dL)
SHBG: 44 mol/L (Reference Range: 22-77 nmol/L)
Testosterone Bioavailable: 190.1 ng/dL (Reference Range: 110.0-575.0 ng/dL)
Free Testosterone: 88.7 pg/ml (Reference Range: 46.0-224.0 pg/mL)
Albumin: 4.7 g/dL (Reference Range: 3.6-5.1 g/dL)
My LH and FSH are high above normal, but that's expected I think given how EC works.

All other labs are within normal range, including cholesterol, B12, Vit-E, Folate, Calcium, Potassium, etc.

It seems that EC works well in increasing testosterone, no questions about it. These numbers look good, however, I don't feel any different and most of the issues I related above remain the same. There may be a perhaps small almost unnoticeable improvement in general, but definitely not proportional with the increase in T.

Question, could it be that because I was subjected to low T for so long (more than 15 years) my body has slowly gotten used it and now it may take a few months for the body to recognize the new balance and start adjusting accordingly?

Any other "old" people here with similar experiences? This is definitely NOT like the wonderful but short-lived experience I had with HCG.

****
Edited the post because I found this that gives me hope and is in line with my hypothesis above. It was using Clomiphene, but close enough I guess....

"In elderly men with erectile dysfunction, Guay and colleagues13 found that the use of clomiphene citrate for 2-months raised LH, FSH, and testosterone levels; however, despite the increase in serum testosterone, sexual function in these elderly men did not significantly improve. However, a follow-up study with an extended 4-month duration of treatment with clomiphene did demonstrate an improvement in sexual function in 75% of men with secondary hypogonadism and erectile dysfunction, confirming that improvement in hypogonadal symptoms may require at least 3 months of eugonadal levels before symptoms improve"

The Role of Estrogen Modulators in Male Hypogonadism and Infertility

******

Thanks everyone!

 

[DragonBits]

As others pointed out many on Clomid are disappointed with libido. I don't think the libido aspect of clomid has ever been studied, but it makes sense that this might happen. Clomid works by blocking estrogent senors in the body, however, estradiol in men is essential for modulating libido and erectile function. So my guess is that this is the reason blocking estrogen receptors while raising testosterone doesn't nothing or even hurts libido. But you should get more energy and be able to grow muscle. Even though your estrogen may be high when using clomid, your body cannot sense this.

In your case, HCG should work, though many have mixed reactions to HCG. Understandable, as first you need to have secondary hypogonadism for it to work at all, then there a numerous comments about different brands working differently.

You have relatively high SHBG, I would think either EOD or once weekly testosterone cypionate should work well, and it's usually cheap enough. For those with low shbg, it seems more frequent injections of smaller amounts works better.

I am 69 and have used testosterone esters, clomid, hcg and creams, but only used clomid for 3 or so months to improve fertility, I don't think it helped libido, but I wasn't focusing on that aspect at the time.

Sleep is a whole other subject, it's hard to say how sleep will be affected by the hormones we have discussed. Sleep apnea is often made worse when raising testosterone, but I don't have that problem so no experience with that.