My new Labs. Low Libido

Hi guys, Ives been doing really Great since I've been on Testosterone injections but lately my libido have crashed. So I went to my Dr. and have some blood drawn. This is what he found.

total Testosterone 920 348-1197
Free Testosterone 36.6 7.2-24 HIGH
Sex Hormone Binding Glob 16.5 19.3-76.4 LOW
Estradiol 29.8 7.6-42.6

I am on Testosterone injections 200 mg Cypinate nn .30 2 times a week, and HGC 500 3 times a week...

Can anyone see what happened to my Libido....I'm really down and have no sex drive

My Dr. told me to lower my injections to .25, and i did this but nothing really changed. ???

I'm in the same boat, whenever I am on a given TRT protocol for any length of time my libido tanks.

You could try testing prolactin, see the comment by Dr. Crisler in this thread:
A new option for orgasm problems in men

Nelson, Gene, and Super Dave will have the best replies as they are the most knowledgeable. Quick question to the OP. You are taking 200 mg twice a week? Or two injections totaling 200 mg in a week?

Also, I too was prescribed 500 units of hcg three times a week. I've learned that might be a bit much. Id like to hear what the big 3 have to say.

Hi Chris - Let me start off first by saying the libido is far far more complex than just labs as we all know. The Sympathetic and Parasympathetic pathways are dependent upon so many physiological variables it's not even funny. Throw one of them off and libido is impact in a negative way.

I do agree on 500 units of HCG each injection is a bit too much. You would be better served at 250 units three times a week like the mornings of Mon, Wed and Fri and save yourself some money to boot!

I also agree that a Prolactin lab would be one to look at as well. Even just mid level range of the serum level can suppress libido. Dr. Eugene Shippen proscribes Cabergoline to his guys when libido is suppressed and Prolactin is mid to high on the reference range.

I take .25 mg of Cabergoline twice weekly on injection days and all I can tell you is my libido is on fire day in and day out not discounting the fact that it also makes my orgasms more intense and refractory times even better (I can orgasm twice per session).

Another important lab is DHT. DHT is converted from Testosterone and is 7 to 10 times more androgenic than Testosterone and is one major hormone for driving libido. Some men don't convert to DHT very well and this can impact libido in a big way as well.

Another huge impact on libido is lifestyle and stress even sleep can impact libido. Has anything in your life changed recently...and undue stress?

Finally, stop worrying about it; sometimes just thinking about low libido will drive down libido.

Agree with Gene on everything, including the stress element. This is where things can start getting complicated with the adrenals (imbalance with cortisol, DHEA), which then can interact with glucose and thyroid activity, leading to inadequate ATP productivity and down the line ...!

IMO, you need to factor a whole litany of variables when administering TRT, as a variety of issues can develop upstream and downstream.

Poor sleep, stress, and lack of "mental time" for sex have a stronger influence on sex drive than hormones. Your hormone values are great. I doubt that you will have a prolactin issue, but it would be good to see.

I have had numbers like yours and have had low to no sex drive when I am too busy with work, my mind is racing with work and personal issues, I am not getting enough sleep, or I have not "made time" for sex. I find myself "jump starting" my sex drive with a little porn, taking time to relax, taking low dose daily Levitra (Cialis kicks my butt) and making sure I get 8 hours of sleep (this last one has been a difficult task).

Here is pretty simple but good diagram on factors associated with sex drive that go beyond testosterone.

Guys, Thanks for all your comments, and to answer some of of your questions, 1st I use 200 mg/ml testestorone cypionate .30 2 times a week. Also, its not the will to have sex, I want it, but its the physicial problem with getting and maintaining an eriction. So my question to all of you, do my Labs look to be in range? My Dr. Says my free testostrone is too high and he wants me to lower my injections to .25 2 times a week. Aslo to answer the most important question, Yes i do have a lot of stress for the past 2 months. My wife is going thru full blown menopause and her drive is "Zero". And ive had a lot of frustration with helping her enjoy sex again. We are now seeing my Dr. Togather and have just taken blood to check he levels. Thanks again to all you guys, your a Great help .......

Oh, so you do have libido but have erectile dysfunction; is that correct?

If so, that's a different discussion all together with different solutions.

Please advise.

Low libido is diffent than erectile dysfunction, although they can both happen together.

If your erections are not good enough but you have libido, try using low dose daily Cialis (5 or 10 mg per day) along with your TRT+HCG

You can get a free one month supply to try it (you need your doctor to write you a prescription and take the coupon to the pharmacy):

Free Cialis Trial

Well to answer the questions correctly. When I started my injections in January of this year my Libido was really low, and then gradually it rose to a super high after about 3 months, ever since then my erections have been really good. I was injecting .30 2 times a week and after some blood work my Dr. told me to go down to .25 because my free testosterone was at 36. Please look at my labs that I started the Post with. So now i did and I'm experiencing a low Libido and ok erections. So let me ask you guys. Is a Free testosterone level of 36 something to worry about. Because if not id like to go back to .30 again and see if this fixes my issues. Or even go a little higher on my injections. Another issues I was using Anastrozole for maintenance of of estrogen and when I took a 1 mg tablet 2 times a week my libido sky rocketed, but my Dr. says to stop taking it because my estrogen is looking OK. So are my Labs looking OK? , and does anyone have any other suggestions on medications and doses for my Low libido? One last thing , my Dr. told me to take .50mg of DHEA. Now maybe this is causing my problems. ?

Chris - this E2 thing is so complex. I understand libido/erections are two different things and there's a host of factors which help determine it at any given point, but I had the same experience with an AI. I've been on TRT for 7 months and although my E2 was very much in "normal" range, I had a few things that caused me to think I needed an AI. Fought the Dr because my level was in the upper normal range and finally got it. I've had a very low dose of 1/4 Arimidex, once a week, both last week and this week and those challenges quickly went away. I feel great and my libido is through the roof. Bottom line - those normal ranges you get fed certainly have a purpose, but they're meant as a general guide. I hate when doc's spend more time directing your treatment based on bloodwork than how you feel. Sounds like your dose of anastrozole may be a little higher than most would take/need, but if your E2 is still in the range that we accept as normal and you feel good/healthy/strong, why change it? Low dose AI has been a God send for me is so many ways, even though the doc would say it's not needed because my E2 is at the very top of what is accepted as normal.

Chris, was this E2 assay specific being "sensitive" or "ultra-sensitive"? I can tell by the range values that it's not a Labcorp sensitive assay.

Just for discussion sake on the free testosterone, for me being in the upper teens, low 20's is more than sufficient. Your SHBG is low, but doesn't seem low enough to warrant free test to be in the 4% arena, but who knows, maybe your albumin is way up. My SHBG is high single digits, but free test just over 3%. Either way, the trick is to adjust serum levels that will provide the adequate (sweet zone) of free & bio-available testosterone.

Anyways, it would be good seeing what your E2 is looking like on the Labcorp sensitive assay, I believe the ranges are 3-to-70, but don't have one in front of me.

Vettester Chris said:

I believe the ranges are 3-to-70, but don't have one in front of me.

Click to expand...

Correct, as expected.