10 Years on TRT and Only Recent Libido Issues

wes6363

New Member
Hello All,
First, thank you all for you knowledge throughout the years, it has certainly helped. I have used this forum often in the past for questions on topics and I appreciate it. I have never had to post as most of the answers were located in the threads on here, so I will try to make this short for review.

Backstory- Have been on TRT due to cancer since 2015, with generally decent results overall. Over the past 8-12 months, I have been having extreme libido issues, as in zero libido. Protocol was 0.2mL (200mg/mL) every 3 days, which usually put me in the 800-850 TT range (and has been for the past 6 years or so). Labs looked good, so I thought, maybe I need to increase my dose. Doc put me on 0.3mL (200 mg/mL) twice a week, or 0.6mL a week. Unfortunately no change, besides maybe some better gym gains. Other symptoms- motivation slightly less and not quite as much energy. Performance from an intimacy aspect not really an issue, just the drive. Upcoming endo appointment in June.

Supplements- L-Dopa (recent), L-Tyrosine (recent), MV, calcium, DIM (recent). Started the L-Dopa & Tyro as I thought maybe a dopamine issue. No changes but some more energy. No other meds that cause libido side effects.

Rule out- I have tried to rule out everything possible, both with the help of docs and ordering labs myself. Saw a psych and sex therapist just in case, nothing that they could identify. I also do not drink, smoke or anything else recreational. Lifestyle wise, no issues or abnormal stressors and I workout 3-4 times a week.

Labs- These are all recent labs, within the past 30 days.
CBC- all normal
CMP- all normal
Lipid- HDL a little low at 34 and LDL a little high
A1C- 5.3 normal
Total T- 1265
Free T- 27.1 (8.7-25.1)
SHBG- 38.4 (16.5-55.9)
E2- 25 (11-44) 4/8/25
DHEA- 203 (89-427)
FT3/FT4/TSH- normal
PSA- normal
Cortisol Random- 10.6 (no ref)
Prolactin- 8.0 (4.0-26)
IFG1- 164 (72-228)
HGH- 3.82 (<2.47)

That's where I am so far and completely stumped. Besides libido, I overall feel well, but I have no idea why it just gradually disappeared. I'm also curious why my HGH would be elevated, but maybe it was random. I looked through other discussions and felt like this one was different, so I apologize if it seems repetitive to another. Open to any suggestions or ideas that y'all may have. Thanks in advance.
 
Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.
 
Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.
Agree here, don't try messing dopamine. My buddy started using those zyn nicotine pouches for a dopamine boost well after a year he decided to quit because he had to use more and more for a benefit. After quitting he had minor depression, fatigue, no libido....took about 5-6 months to level back out. Granted nicotine is stronger on the dopamine pathways than supplements, just be very cautious. Also agree with systemlord, maybe try boosting E2, with some low dose DHEA maybe 10mg daily or very low dose HCG. you don't want to overshoot E2. Also don't try the cabergoline or pramipexole as suggested your prolactin is already low.
 
Protocol was 0.2mL (200mg/mL) every 3 days, which usually put me in the 800-850 TT range (and has been for the past 6 years or so). Labs looked good, so I thought, maybe I need to increase my dose. Doc put me on 0.3mL (200 mg/mL) twice a week, or 0.6mL a week.
The libido issues started on your old protocol? Increasing the dose to supraphysiologic levels never seems to work and can even make it worse.
 
I also have been on TRT for 10 plus years. My libido and orgasms are still very strong. I do inject 500 iu of HCG every third day.
 
Personally would never use DIM and would be very very careful with Calcium as it needs proper D3 and K2 dose to balance things out else you might be driving all that calcium to wrong areas think atherosclerosis. Also needs a lot more cofactors and proper testing and knowledge to be able to understand and manage all this. Also when you have so many moving parts and esp new ones, figuring out whats happening is next to impossible. Less is more esp when fucking with your own dopamine levels that might mess you up big time and for longer. Usually these experiments go full circle and never yield much long-term benefits if you know what I mean.
Thank you. My last provider suggested the DIM with the new regimen. I can’t say I’ve noticed any difference, but less is more is a good point.

@SS1LE @Systemlord yeah the dopamine was a last ditch effort that I started a month ago. I’ve been doing 5 days on, 2 off. To Belekas’ point as well, I’ll ween off so there isn’t as much going on. I do have an AI on hand, but only take PRN (around 0.5mg arimidex every 4-6 weeks). I imagine my E2 is a little higher since I had that one done a couple of weeks ago.

@Willyt symptoms started around 8-12 months ago on the old protocol and has progressively declined. I started the new protocol 2 months ago or so.

@Vince My PCP does the TRT, so I doubt they’ll give me hCG. She wasn’t sure what to do and referred me to endo, which I don’t think will be a big help either.

@Seagal admittedly, definitely don’t train that hard, although I’d like to say I do lol. I did just take a week off though about 3 weeks ago.

I’ve had low and high E2 several times throughout my TRT journey. This time is just weird to have absolutely no drive. And no symptoms of irritability, emotional, etc. I’ll ween off the unneeded supplements asap.
 

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