Failing to Finish

Hi folks,

I just turned 49, fit, ideal weight, no medical issues aside from low T. I'm current injecting T & HCG twice per week subQ and taking Anastrozole 3x per week. Labs show my T levels are 800-1100 and my E at 20. I've also recently started 2.5mg of Tadalafil a day to try & boost drive a bit.

My issue is that my drive just isn't strong and I'm suffering on some occasions going mostly numb during intercourse and an inability to finish. Erections are no problem. Yesterday for my b-day my wife welcomed me home in a spectacular outfit, sexy as hell, and wanting to stare at her a while, we had 1/2 a drink together before heading to the bedroom. But soon I went numb and it was just a total disaster for me (her body didn't let her down at all).

Afterwards she pointed out this was the 3rd day in a row we'd had intercourse and thought I'm stressed with work so maybe that explains it. We went to dinner and afterwards I peeked at a sexy video of us and then I was able to finish from her giving me oral.

My question is this: what can cause conditions where E is no problem, but sensitivity vaporizes and I can't finish? Is there anything that can be done?

Also: with my numbers, I'd expect my libido to be high, but it's not. My goal is to get back to how I felt at 45 where I was pining to have sex each day. Is there help for me or is that unrealistic?

Thanks!

lakecoder said:

Hi folks,

I just turned 49, fit, ideal weight, no medical issues aside from low T. I'm current injecting T & HCG twice per week subQ and taking Anastrozole 3x per week. Labs show my T levels are 800-1100 and my E at 20. I've also recently started 2.5mg of Tadalafil a day to try & boost drive a bit.

My issue is that my drive just isn't strong and I'm suffering on some occasions going mostly numb during intercourse and an inability to finish. Erections are no problem. Yesterday for my b-day my wife welcomed me home in a spectacular outfit, sexy as hell, and wanting to stare at her a while, we had 1/2 a drink together before heading to the bedroom. But soon I went numb and it was just a total disaster for me (her body didn't let her down at all).

Afterwards she pointed out this was the 3rd day in a row we'd had intercourse and thought I'm stressed with work so maybe that explains it. We went to dinner and afterwards I peeked at a sexy video of us and then I was able to finish from her giving me oral.

My question is this: what can cause conditions where E is no problem, but sensitivity vaporizes and I can't finish? Is there anything that can be done?

Also: with my numbers, I'd expect my libido to be high, but it's not. My goal is to get back to how I felt at 45 where I was pining to have sex each day. Is there help for me or is that unrealistic?

Thanks!

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Welcome to Excelmale.

Was your estradiol measured with the sensitive, LC,MMS/MS, lab test, the only one that can accurately determine e2 levels in men? How much anastrozole are you taking, and what prompted it to be prescribed? Typically, it's not called for unless levels, as measured with the proper test, are high, and symptoms associated with those high levels present themselves. Low estradiol - and if that is an accurate number, you are tending low - can effect a loss of sensation and an inability to climax, just as higher levels can.

Hi CW,

I've been with Defy since about February this year, so yes they definitely use the sensitive test. So last year, prior to Defy, my local Urologist/DO started me on pellets and my E2 reached 118. Starting Defy & subQ injections it came down to 37 but felt it was still too high, so they prescribed me Anastrozole. Early summer I told them my libido still didn't feel great, so they bumped me to A 0.25 mg caps 3x per week, and added me on DHEA and DIM. Been on that protocol for 3-4 months and I can't say that's improved my drive. Unfortunately my Hematocrit has now risen to 52.4% and so they want me to give a unit of blood

Do you think my E2 is too low now?

So 20 is "tending low" per CoastWatcher, but Defy was trying to lower it when it had come down to 37. Interesting. Some guys feel great letting it go to 50 or so. The thinking on this site seems to be slanted toward letting E2 be a bit higher and avoiding AIs if possible.

What is your free T? SHBG? Those numbers could help understand where your free E2 might be.

Your problem is not uncommon, and is certainly frustrating. Take look at prolactin and cabergoline (if indicated, do a search here, and ask Defy). And if you're not living a healthy lifestyle, address that, of course. Unfortunately, there are no easy answers. Hopefully it will be just a temporary thing, but in my experience it becomes more frequent with age. That is just my experience, of course. Good luck!

Another thing to consider is that your T is too high. Elevated T has a calming (anxiolytic) effect via gaba receptors in the brain. This can also cause the lack of sensation or responsiveness you mention. For example, drugs like gabapentin can cause anorgasmia or delayed ejaculation by this mechanism. It might not make sense at first, but at least keep this in mind. If all else fails, consider reducing your T dosage (in consultation with you doc, of course).

I had that exact problem as well. I had hardly any sensation. Erections no problem and by accident my MD noticed my progesterone was low on my labs and he told me to get some cream for that and use it. So I did and it worked miracles. I had great sensation after that. Ironically progesterone cream has 22mg per 1/4 teaspoon and I estimate that I take approx. 4mg daily of cream, very little. So it's not much but it made me feel like I was 16 again.. literally I could have sex again several times a day from that point fwd and the orgasms were incredible. Of course the wife wasn't overly pleased with that.

Another benefit of lowering your T would be your hematocrit should come down. So you might feel better and have your hematocrit at a better level (and not have to donate) at a total T of, say, 500 - 700 vs your current 800 - 1000. Just a thought.

As rat noted, progesterone and/or prolactin imbalances can sometimes be the culprit with that. Years back, my prolactin was a little high, and closing the deal was quite difficult. A little cabergoline (dopamine agonist) got that situated real quick.

I was on daily cialis. It helped my erections tremendously, but it wasn't long before I started losing sensation. . . aka "Zombie D*ck". My doctor could not explain the zombie D, but he did say it could be a side effect of the cialis.

I should have noted that I do apply about 8mg of progesterone cream a day (to the boys), starting this summer. At first I felt it gave me a bit of zing but now less so. I did that on my own, from another forum's recommendation - not Defy.

I have to say my last Defy consult was not great. It was a new (I think?) employee, a female PA, and she just seemed very pleased with my numbers. Only after that consult did my "Zombie D*ck" return.

On 9/20 my free T was 21.6 ng/dl and SHGB was 19 nmol/L

As if Zombies weren't bad enough!

I think Lakecoder had this issue before starting Tadalafil/Cialis, but I could be wrong. Also, Lakecoder, was this an issue before starting TRT? If so, has it worsened since then?

I did have this issue on & off since before starting Cialis. It was also an issue from before starting TRT. My first T check was on 1/21/16 and it was [FONT=Calibri, Arial, sans-serif]243. The T therapy has definitely helped some there but it's massively helped me in the overall life mojo department.

Someone asked if I was living healthy and the answer is yes, absolutely. I'm in shape, decently-low body fat, eat pretty well, exercise regularly (HIIT), etc.[/FONT]

Just because youre with Defy does not mean that the lab is running the correct test, not at all.

Opinions vary about E, as noted on EM we side on the higher side with less or no use of an AI. "IF" that 20 was the correct test, most knowledgeable folks are going to state that its getting on the low side. Will that fix the sensitivity problem though...hard to say. Penile sensitivity downgrade isn't an uncommon thing for TRT guys. Can you try Viagra and ditch the Cialis? Ive been there....had to stop my sex act of choice at the feeling was way down and there was just no way I was going to orgasm.

Yeah, I figured a new consult, with a doc this time, might be in my future.

On a side note, I told a friend of mine who's a (fairly?) knowledgeable urologist how Defy had me also taking DHEA and DIM along with HCG. He about flipped, saying the DHEA is nearly pure testosterone and that I'm dumping far too much into my system. Might that be hurting my sensitivity?

Surprised nobody has asked this yet, have you used any of the following drugs?
1. SSRI's (anti-depressants)
2. Finasteride
3. Isotretinoin (aka Accutane)

Vince, he had the problem before starting Cialis, so it is doubtful that switching to Viagra will help. This is a difficult problem for a lot of men. I know you have tried cabergoline and it didn't work for you. I do know that as testosterone increases, sensitivity *can* decrease for some men. But Lakecoder had this problem before even starting TRT. So my thought would be to check prolactin and if it is high or even high normal, do a trial of cabergoline. Otherwise, pray he has a very patient wife because this sort of thing can ruin relationships where no one is really to blame.

Another thing to check out, if you have not done so already, is to look at your thyroid function. It's another shot in the dark, but a low functioning thyroid can cause these symptoms. This site has great resources on thyroid function and testing.

And your wife might be on to something regarding stress (or other psychological stuff). Unfortunately, the pills for that (other than perhaps bupropion) tend to worsen sexual function. Doing new and different things with her that help you bond in other (non-sexual) ways might help. We can all fall into ruts that dull our relationships and brains. Good luck to you both.

@DaveK22 No, none of those.

TMI said:

Vince, he had the problem before starting Cialis, so it is doubtful that switching to Viagra will help. This is a difficult problem for a lot of men. I know you have tried cabergoline and it didn't work for you. I do know that as testosterone increases, sensitivity *can* decrease for some men. But Lakecoder had this problem before even starting TRT. So my thought would be to check prolactin and if it is high or even high normal, do a trial of cabergoline. Otherwise, pray he has a very patient wife because this sort of thing can ruin relationships where no one is really to blame.

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I have a much better experience with Viagra, no doubt.