A change in morning erections - high E2

[albatross]

I have been on TRT for 18 months initially on Sustanon and now on 100mg Test E a week and 200iu HCG every 2 days

Blood work was all over the place on Sustanon. I had thought I had achieved some stability from November through to January on my new Test E/HCG protocol.

Latest bloods now indicate a climb in Test to 1200 from 900 and a rapid climb of E2 from 35 to 65 pg/ml. Also Prolactin has come down to midrange and SHBG has climbed from 36 to 45. My Hematocrit has climbed to 53 which is starting to cause concern.

I have lost 17 pounds in weight since the new year and weirdly I now feel the best I have ever felt on TRT. Morning wood actually wakes me up about 3 times from about 4:30 am till my 6am alarm clock and has done for the last 3 weeks. What I mean is that the erection is so strong that it is almost uncomfortable. Is this something to worry about?

 

[Vince]

I have been on TRT for 18 months initially on Sustanon and now on 100mg Test E a week and 200iu HCG every 2 days

Blood work was all over the place on Sustanon. I had thought I had achieved some stability from November through to January on my new Test E/HCG protocol.

Latest bloods now indicate a climb in Test to 1200 from 900 and a rapid climb of E2 from 35 to 65 pg/ml. Also Prolactin has come down to midrange and SHBG has climbed from 36 to 45. My Hematocrit has climbed to 53 which is starting to cause concern.

I have lost 17 pounds in weight since the new year and weirdly I now feel the best I have ever felt on TRT. Morning wood actually wakes me up about 3 times from about 4:30 am till my 6am alarm clock and has done for the last 3 weeks. What I mean is that the erection is so strong that it is almost uncomfortable. Is this something to worry about?

I wouldn't worry too much about your morning wood. I get the same thing starting around 2 a.m. I guess that means you can't sleep on your stomach.

 

[Gman86]

Were these labs done at trough? And what was your free T? Regardless, sounds like things are going great. I wouldn’t change a thing. Why would rock hard morning would be concerning? If any guy had a choice of no morning wood, or rock hard morning would that wakes him up, I think you know what every guy is gonna choose. Plus, it’s a great sign that things are dialing in.

 

[albatross]

Yes it was at trough although as I split my dose into twice weekly 50mg, trough means only 3.5 days. Free T was .913 nmol/L.

I think maybe because it is so unusual for me, I am in my 50s and I have never had erections actually wake me up so consistently and with such an uncomfortable ache. makes me think that something is wrong. My doctor is concerned that I am running too high with my testosterone levels and it is pushing E2 and Hemocrit up so I might have to titrate down a bit with the Enanthate.

 

[Indy57]

I agree-it means you are in the “sweet spot” and should get repeat blood work pronto. Your current T and E levels may be optimal for you.

 

[S1W]

Yes it was at trough although as I split my dose into twice weekly 50mg, trough means only 3.5 days. Free T was .913 nmol/L.

I think maybe because it is so unusual for me, I am in my 50s and I have never had erections actually wake me up so consistently and with such an uncomfortable ache. makes me think that something is wrong. My doctor is concerned that I am running too high with my testosterone levels and it is pushing E2 and Hemocrit up so I might have to titrate down a bit with the Enanthate.

When you mention painful erections it made me think Peyronies. Have you ever injured your penis during sex or otherwise, that you’re aware of? Did you have any issues with maintaining erections before TRT? Any curvature to your erections?

 

[SkiDaddy]

Don't do what so many do, find where they feel the best, lost weight, great erections then start changing things because of other opinions.
What you have is you found where you are Optimal !!!
Just my opinion but be Happy and Enjoy. When you are optimal, erections are like in your early years, at least with me when I was young my Erections ached until I had sex.
I just started letting my E2 rise and that is what helped get those Aching Erections back.

 

[Gman86]

Yes it was at trough although as I split my dose into twice weekly 50mg, trough means only 3.5 days. Free T was .913 nmol/L.

I think maybe because it is so unusual for me, I am in my 50s and I have never had erections actually wake me up so consistently and with such an uncomfortable ache. makes me think that something is wrong. My doctor is concerned that I am running too high with my testosterone levels and it is pushing E2 and Hemocrit up so I might have to titrate down a bit with the Enanthate.

Do you have a range for your free T? It’s just an unusually measurement, never seen it before. Just wondering if your free T is in a good spot. But it really doesn’t matter too much, if you’re feeling great, and morning wood is hard as a rock, I wouldn’t mess with your dose at all. I would ask your doctor if you can stay right where you are. HCT isn’t too high at 53. If it goes any higher, I would just try donating blood.

 

[Vince]

I agree just donate blood, after a time hopefully your HCT should stabilize. You may want to use fish oil and baby aspirin just to keep your blood slippery.

 

[albatross]

No Peyronies or anything like that, no real trouble with erections before but this last few weeks has just turned everything up to 11 with regards morning wood.

The free T of .913 is in nmol/L with a range of 0.174 - 0.729

 

[Cataceous]

...
Latest bloods now indicate a climb in Test to 1200 from 900 and a rapid climb of E2 from 35 to 65 pg/ml. Also Prolactin has come down to midrange and SHBG has climbed from 36 to 45. ...

I find your numbers interesting from a theoretical standpoint; the changes make some general sense, even if the original cause is unclear: higher SHBG may mean higher total testosterone, even when exogenous dosing is static. Higher testosterone typically means higher estradiol. And higher estradiol can stimulate higher SHBG production in the liver. Presumably there's not runaway positive feedback because SHBG production is influenced by many things aside from estradiol.

 

[jdthoosier]

I've been on TRT nearly 5 years, and my morning wood has been variable all this time. It's been much better the past few weeks and I'm not sure entirely why. Like you it seems to start about 4:30 in the morning and wakes me up. I nod off and then it comes back again.
For me, it's not painful but it's strong enough to wake me, and it does not fade quickly.

The only thing I've done recently is add Kyolic garlic 2x a day with meals.

 

[tropicaldaze1950]

I find this fascinating. IM or sub q? I'm 68 and, working with my urologist, have tried different dosing schedules and dosages over the past few years, yet to find the sweet spot. All I do is gain weight around the middle. When I started TRT, my doctor prescribed 100 mg, weekly, in a single dose. For awhile, I did experience great erections, but they faded. I know that there's no formula and what works for one man might not work for someone else. Never been on HcG and have read that it increases E2. I recall an abstract that concluded that low E2 is responsible for weight gain and higher E2 is preferable for weight loss and erectile function. However, I'm concerned that I'll just keep gaining weight(fat). But, perhaps the contrarian view is worth pursuing, that is, letting E2 rise.

 

[albatross]

That was IM but I am seriously considering switching to sub q or at least giving it a one month trial. I think my E2 is too high at 65 pg/ml and I would hope the slower absorption via sub q would bring E2 down but who knows?

 

[tropicaldaze1950]

"Who knows" is correct! Dr. Henry Lindner, an interventional endocrinologist, prescribes once weekly 100 mg sub q or at least he was a few years ago, according to his website. And he ignored E2, posting many abstracts that refute the conventional wisdom of managing it with an AI. I share the opinion of the other posters who seem to be saying, 'If it ain't broke, don't fix it.' You might be one of those men who, indeed, gets a better response from running high E2. And that you lost weight, too...!!! You didn't mention your PSA or any prostate issues, so I'll presume you're within range and negative for prostate problems. Right now, I only dream of tent pole morning erections or making love to my wife until she begs me to stop.