24 on TRT with Low Libido

[Borneo]

Im 24 and was diagnosed with hypogonodism. My doctor put me on TRT 2 month ago.

We started with 75mg of T-enanthate every 3.5 days IM.
Bloods after two weeks:
Testosterone Total:1103 ng/dl
E2: 45 pg/ml
Libido was better than before TRT but not great, for the first time in a while i had morning erections though not as strong as the first week.
Doctor suspected its because of E2 and decided to taper off the dosage.

We then lowered the dosage to 50mg every 3.5 days and introduced HCG to the regimen, 350IU the day after T injection (twice a week).
Bloods 3 after introducing the new regimen:
Testosterone Total: 1100 ng/dl
E2: 65 pg/ml
Libido is again non existent, worse than the first two weeks.

The doctor decided to take me off HCG for a few weeks and then introduce it back on lower dosage (250 iu twice a week).
its been 3 weeks since getting off HCG and libido is still non existent. The doctor said that if that wont help with E2 then we will start using and AI (Arimidex).

When starting TRT i wanted to abstain as much as possible from AI, but that doesn't seem possible anymore.
what do you guys think i should do? and if i start using an AI what would be a safe dosage to start with?
(My doctor is willing to listen to my concerns so i believe i can convince him to give me the dosage i want for AI.)

P.S
There is no Sensitive E2 test in my country

 

[Systemlord]

A lot of guys go through what's referred to as a TRT honeymoon period where you have symptom relief or improved libido followed by a period of feeling run down, it's perfectly normal since your HPTA is now shutdown. It take a lot of guys months to begin to feel changes, I'm almost 6 months into TRT and changes are happening slowly.

Did you have SHBG tested? This will aid you in finding what protocol is best for you, a lot of doctors fail to run this important test. I would mess around with dosing first before going to an AI, then if you're unable to lower your E2 into range you may require an AI. Just be sure not to make changes to your protocol before you reach a steady state each time you adjust your protocol, steady state is usually reached in 4-6 weeks.

If you make changes to often you never know what works and what doesn't.

 

[Borneo]

I had SHBG tested about a year ago, before starting TRT, and it was 27 nmol/l. but i can add it to my next blood tests.
If im understading correctly, there's a chance that my e2 will go down by itself in the next few months when my body "adapts" to the TRT?

also i know high shbg and e2 is correlated with high body fat and the lack of exercise.
Im fairly lean (12-14%), and have descent muscle mass and exercise regularly.

 

[Systemlord]

I had SHBG tested about a year ago, before starting TRT, and it was 27 nmol/l. but i can add it to my next blood tests.
If im understading correctly, there's a chance that my e2 will go down by itself in the next few months when my body "adapts" to the TRT?

also i know high shbg and e2 is correlated with high body fat and the lack of exercise.
Im fairly lean (12-14%), and have descent muscle mass and exercise regularly.

Levels are still fluctuating within the 4-6 weeks and it could take longer for the body adjust to the new test levels, your E2 levels should stabilize within the 4-6 week adjustment period, adjusting your dosage could help manage your E2 levels. The first 4 months I experienced inconsistent energy levels from day to day and I started feeling more energy consistently in the 5th month. Some have been able to discontinue their AI once they lost tons of weight. You're going to have to go based on how you feel to manage your E2, the non-sensitive E2 test is pretty much useless for males as it overestimates.

 

[CoastWatcher]

Keep in mind that libido is a tricky thing to bring online. It's the sum total of so many factors, physical and psychological. You are very, very young to be hypogonadal. What efforts were undertaken to determine if you are primary or secondary? Was your thyroid function fully evaluated?

 

[Borneo]

Yes, i went to an endo and she tested everything, including Thyroid. I even got a brain MRI to test for prolactinoma, which came back ok. I have secondary hypogonadism, I tested LH and FSH constantly for two years prior to starting TRT, and it always came back low (2-3 iu/l for both of them).

 

[at15]

I would move to one injection per week. You may be one of these guys where steady state levels are troublesome. They resemble more of an old man whereas 1 inject per week fluctuates more like a young man. Go to 100mg 1x/wk and take your 250 hcg on each of the 2 days before your inject.

 

[Vince Carter]

Yes, i went to an endo and she tested everything, including Thyroid. I even got a brain MRI to test for prolactinoma, which came back ok. I have secondary hypogonadism, I tested LH and FSH constantly for two years prior to starting TRT, and it always came back low (2-3 iu/l for both of them).

If you have labs we'd like to see an attachment or screenshot...Endo's on this forum, have a terrible reputation in this area and often "OK" or "in range" is very far from actually being any where close to good. Of note here is that lab ranges are not healthy ranges that any Dr or scientist has determined as healthy. Lab ranges are mere ranges in the tests of the population that the lab is testing.