Here's a scary thought: Long term LH suppression on TRT- What are the effects?

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frankwhite

New Member
I'm not a doctor, although I've had to educate 2 of my last doctors about TRT, HCG, even sitting with one doctor for 30 minutes making him watch Youtube videos only to have him say, "wow, that's interesting, I dodn't know that." I have taken my own 8 years of experience and countless accounts from other guys and I see a pattern emerging. It goes like this:

Guy goes to Dr. with classic symptoms - low energy, sexual/ED issues etc.
Guy is diagnosed with low testosterone and TRT is started.
Initially there is improvement.
The improvement lasts for 6 months, 1 year, 5 years... different for every guy.
Eventually the improvement disappears and sexual/ED issues come back worse than ever.
Maybe HCG is started if he wasn't doing it already.
Again there is an initial improvement.
Again the improvement disappears with time and sexual/ED issues come back even worse than before.

This is happening A LOT. It's happening more and more as guys are on TRT for longer periods of time, and we have no understanding of what is happening. Think about this...

Long term testosterone = long term LH suppression.
LH does more than just stimulate testicular leydig cells. LH binds to receptor sites all up and down the penis. I'm guessing that over time when those receptor sites are empty is when you start to lose penis sensitivity (more and more complaints of sensitivity issues every day) and your penis seems to shrink, weaken, and shrivel up. Which makes sense when we see HCG providing an initial improvement. HCG mimics LH, fills those receptor sites, and for a while sensitivity comes back. There are even reports of guys swearing HCG made their penis bigger/longer, which makes sense. But over time the HCG stops working, and you're left where many of us are now - on TRT for a few years, symptoms got better, then they got much worse. And for the last few years we have been experimenting with every possible thing - more test, more hcg, less test, less hcg, estrogen manipulation, stopping all together to see if we can just get back to "normal." It's absolutely maddening and it's getting worse.

If you haven't experience any of this yet, good for you. But you probably will at some point based on the amount of guys with the same story.

Would love to hear comments from one of the doctors on this forum.
 
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sh1973

Well-Known Member
I've experienced most of what you're saying and have been on TRT most of the last 8 years. My biggest problem has been lacking libido. Energy for the most part has remained pretty well and mood. I agree, it can be maddening trying to figure things out. I am working with Defy and my own doctor at this point to hopefully get a good balance of symptom relief. There's absolutely something to the effects of long term suppression, because I've seen it countless times over the years from guys on these forums and in everyday life. My theory is a lot of men start on too high of a dose and completely overshoot where they would have felt the best. Low and slow is the way to go.
 

Vince

Super Moderator
Frank so if I'm understanding you right. No one should ever be on testosterone replacement therapy, because eventually it will fail you.
 

Blackhawk

Member
Frank so if I'm understanding you right. No one should ever be on testosterone replacement therapy, because eventually it will fail you.

Seems to me more like theorizing/discussing possibilities based on observation rather than a leap to the assumption that it always fails.
 

Nashtide

Member
I'm not a doctor, although I've had to educate 2 of my last doctors about TRT, HCG, even sitting with one doctor for 30 minutes making him watch Youtube videos only to have him say, "wow, that's interesting, I dodn't know that." I have taken my own 8 years of experience and countless accounts from other guys and I see a pattern emerging. It goes like this:

Guy goes to Dr. with classic symptoms - low energy, sexual/ED issues etc.
Guy is diagnosed with low testosterone and TRT is started.
Initially there is improvement.
The improvement lasts for 6 months, 1 year, 5 years... different for every guy.
Eventually the improvement disappears and sexual/ED issues come back worse than ever.
Maybe HCG is started if he wasn't doing it already.
Again there is an initial improvement.
Again the improvement disappears with time and sexual/ED issues come back even worse than before.

This is happening A LOT. It's happening more and more as guys are on TRT for longer periods of time, and we have no understanding of what is happening. Think about this...

Long term testosterone = long term LH suppression.
LH does more than just stimulate testicular leydig cells. LH binds to receptor sites all up and down the penis. I'm guessing that over time when those receptor sites are empty is when you start to lose penis sensitivity (more and more complaints of sensitivity issues every day) and your penis seems to shrink, weaken, and shrivel up. Which makes sense when we see HCG providing an initial improvement. HCG mimics LH, fills those receptor sites, and for a while sensitivity comes back. There are even reports of guys swearing HCG made their penis bigger/longer, which makes sense. But over time the HCG stops working, and you're left where many of us are now - on TRT for a few years, symptoms got better, then they got much worse. And for the last few years we have been experimenting with every possible thing - more test, more hcg, less test, less hcg, estrogen manipulation, stopping all together to see if we can just get back to "normal." It's absolutely maddening and it's getting worse.

If you haven't experience any of this yet, good for you. But you probably will at some point based on the amount of guys with the same story.

Would love to hear comments from one of the doctors on this forum.
I think we need to remember that most guys on these sites come because they are having issues. The vast majority of guys cruising and loving life are too busy getting laid and hitting the gym to be on these forums. So no reasonable conclusion can be drawn.
 

blackebob

Member
I think we need to remember that most guys on these sites come because they are having issues. The vast majority of guys cruising and loving life are too busy getting laid and hitting the gym to be on these forums. So no reasonable conclusion can be drawn.

I do appreciate the fact that there are guys who are busy cruising along, and getting laid while on the way to the gym that take the time to come on here and help. Previous posts on this thread is an example.
 

S1W

Well-Known Member
I agree that it often feels like the wild west - nobody seems to REALLY know what's going on. It would be comforting to see studies showing long term (20-30 year plus) success stories. I would also add, however, that a lot of guys on TRT understand that this is the current state of things and for one reason or another, accept that risk.

Since you brought up ED, an interesting thought is that TRT can supposedly help heal venous leakage, which is a frequent cause of ED. A question might be: when does it become too much of a good thing?
 

frankwhite

New Member
Frank so if I'm understanding you right. No one should ever be on testosterone replacement therapy, because eventually it will fail you.

I'm not sure what I'm saying. Really just thinking out loud. Do you smoke crack? No? Why not? From what I understand it makes you feel ****ing amazing. But if you're like me you probably don't smoke crack because you know the long term negative effects don't justify the short term positive effects. Sounds a lot like TRT as time goes by and the chickens all start coming home to roost, which seems to be happening.

I started TRT because of some relatively mild ED. Did TRT help? I honestly don't know. I started using Viagra around the same time and got great results so I just said meh, no big deal, I can live with taking a pill when I need to. And I kept doing TRT for the other benefits - Good energy, feel good, have a very hard time finding a 45 yr old guy who looks better than me physically. All good stuff. But now the ED is much worse and all of my substantial research and experience indicates that TRT is the cause of the ED, either directly or indirectly. And maybe your story is different but for me, if I look and feel great but my **** doesn't work, I can't imagine living that way forever. You've been on TRT for a while I presume? Can you honestly say you have zero ED/sexual issues? I very highly doubt that. In fact I can't find ONE GUY who has been on TRT for 5, 7, 10 years who doesn't have pretty bad ED issues.
 

sh1973

Well-Known Member
You’re exactly right frank white. I’ve seen countless posts from guys saying around the 5-7 year mark things take a turn for the worse. I’m one of them. I’ve been on trt 8 years and the last three have not been good. My numbers on paper look excellent, but the benefits faded drastically. Basically for the last three years I’ve had zero libido and some ED as well.
 

Systemlord

Member
I'm not sure what I'm saying. Really just thinking out loud. Do you smoke crack? No? Why not? From what I understand it makes you feel ****ing amazing. But if you're like me you probably don't smoke crack because you know the long term negative effects don't justify the short term positive effects. Sounds a lot like TRT as time goes by and the chickens all start coming home to roost, which seems to be happening.

I started TRT because of some relatively mild ED. Did TRT help? I honestly don't know. I started using Viagra around the same time and got great results so I just said meh, no big deal, I can live with taking a pill when I need to. And I kept doing TRT for the other benefits - Good energy, feel good, have a very hard time finding a 45 yr old guy who looks better than me physically. All good stuff. But now the ED is much worse and all of my substantial research and experience indicates that TRT is the cause of the ED, either directly or indirectly. And maybe your story is different but for me, if I look and feel great but my **** doesn't work, I can't imagine living that way forever. You've been on TRT for a while I presume? Can you honestly say you have zero ED/sexual issues? I very highly doubt that. In fact I can't find ONE GUY who has been on TRT for 5, 7, 10 years who doesn't have pretty bad ED issues.

You had mild ED before TRT so how can TRT have "caused" your ED? Sometimes men just get ED because the structure of their penis is no longer healthy, lots of guys get ED who aren't even on TRT. The penis is an organ and organs just fail early in life sometimes do to genes.

You can't attribute everything that happens to you and blame it on TRT.
 
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I'm not sure what I'm saying. Really just thinking out loud. Do you smoke crack? No? Why not? From what I understand it makes you feel ****ing amazing. But if you're like me you probably don't smoke crack because you know the long term negative effects don't justify the short term positive effects. Sounds a lot like TRT as time goes by and the chickens all start coming home to roost, which seems to be happening.

I started TRT because of some relatively mild ED. Did TRT help? I honestly don't know. I started using Viagra around the same time and got great results so I just said meh, no big deal, I can live with taking a pill when I need to. And I kept doing TRT for the other benefits - Good energy, feel good, have a very hard time finding a 45 yr old guy who looks better than me physically. All good stuff. But now the ED is much worse and all of my substantial research and experience indicates that TRT is the cause of the ED, either directly or indirectly. And maybe your story is different but for me, if I look and feel great but my **** doesn't work, I can't imagine living that way forever. You've been on TRT for a while I presume? Can you honestly say you have zero ED/sexual issues? I very highly doubt that. In fact I can't find ONE GUY who has been on TRT for 5, 7, 10 years who doesn't have pretty bad ED issues.

I like outloud thinking. Thanks for the topic and discussion.
I wonder if there should be breaks in TRT much like cyclers (not bikes) have to do but less frequent. On a year off 3 months to allow paths to re form.
 

S1W

Well-Known Member
I do find it disconcerting that I almost never hear from guys who have been on for 10-20+ years, are dialed in and rarely/never need to make changes to their protocol, and are just cruising along. The thought that these guys are just too busy going to the gym and getting laid all the time is a bit hard to swallow...like some of the cheesy banner ads you see out there on T sites with some ripped dude carrying some hot chick. I don't doubt that these success stories exist - I just wish we heard from these guys more often.

So 10-20+ year veterans - if you're out the reading this, please chime in and let us know what your experience has been like.
 
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Systemlord

Member
I do find it disconcerting that I almost never hear from guys who have been on for 10-20+ years, are dialed in and rarely/never need to make changes to their protocol, and are just cruising along. The thought that these guys are just too busy going to the gym and getting laid all the time is a bit hard to swallow...like some of the cheesy banner ads you see out there on T sites with some ripped dude carrying some hot chick. I don't doubt that these success stories exist - I just wish we heard from these guys more often.

So 10-20+ year veterans - if you're out the reading this, please chime in and let us know what your experience has been like.


You're not going to hear from them unless their having problems. Most guys end up here because their doctors are not doing TRT correctly and are having problems as a result. I would never have found these forums if I didn't have a doctor mismanage my treatment to where I was forced to take action, we are force to come here and learn since our doctors refuse or don't have the time to do so.
 

jdthoosier

Active Member
I'm in my 4th year of TRT. I still feel pretty good, not experiencing ED issues. My approach was to find the lowest possible dosages to keep my levels somewhat age appropriate (I'll be 60 this year). I feel like this gives me some space in case I need to tweak things a little. For example, I'm only doing 36 mg of cypionate and 22 IU of HCG twice a week.

My last blood test a few weeks ago showed a total T of 598 and sensitive estradiol of 13.1. I know I feel better with estradiol in the 20's so I guess after consulting with Defy, I'll need to bump up the cypionate a little.
 
Why would HCG stop working? The premise of your hypothesis is that long-term LH deprivation results in deleterious sexual consequences, but there is no logical or scientific basis for the argument that HCG "stops working." If HCG is an analog to LH, then regular concomitant use should have the exact same effect, irrespective of duration. I think a more likely explanation is that androgens are only one component of sexual function, and later on in life many men encounter other issues that interfere with their libido/sexual performance, but instinctively blame trt. I do wonder what role FSH (HMG being the synthetic analog) plays outside of sperm production, and if there are any tangible benefit to using HMG alongside HCG.
 

Neil

Active Member
You had mild ED before TRT so how can TRT have "caused" your ED? Sometimes men just get ED because the structure of their penis is no longer healthy, lots of guys get ED who aren't even on TRT. The penis is an organ and organs just fail early in life sometimes do to genes.

You can't attribute everything that happens to you and blame it on TRT.

I pretty much have to side with Systemlord here
 
I think it is all on you, lots of guys on here in their fifties/sixties who have great pysic and get laid all the time.

I hope I am one of these guys. My wife and I have sex 3-4 times per week. And, yes I do have ED. Cialis was being used before I got on TRT and the doctor told me is would not help with ED. That's not why I got on. I've been on two years and still everything is great.

I do believe it is different for me at age 64 and some of you young guys. There is something going on environmentally that is causing the low levels of guys under 40. I don't know how I'd respond if I was younger and had low testosterone. Being young with low test, ED, and no libido sounds horrible and I don't blame younger guys for seeking some kind of help. My T levels were low, but in range when I got on. I just felt that at age 62 I wanted more for my so called golden years. We have four adult kids, are empty nesters, so what the hell, right? For younger guys, it has to be carefully considered.
 
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