Cypionate + HCG - zero libido :(

philthejuggler

New Member
Hi All!

My first post - I hope you can help me!

I am on 0.2ml Cypionate (200mg/ml - so 40mg) and 250IU HCG 3 times a week (Mon/Wed/Fri). Sub Cutaneous for both.

I sleep well and don't feel fatigue in the daytime (unlike before TRT). I am tapering off Mirtazapine - down to 7.5mg from 30mg 2 months ago.

Libido has never been great on TRT and is currently extremely poor. I was dropping Mirtazapine that I went on years ago before TRT as it was suggested it could impact on libido.

Below are my latest bloods -

I am due a follow-up with my doctor shortly - anyone suggest why libido (and penile sensitivity) is so low?

Is it Oestradiol or Prolactin levels or something else? (Bloods were taken on a Wed morning before my shots).

Thanks in anticipation of your help!

Phil

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It's likely that bringing down prolactin would improvce libido. The high estradiol is helping to push prolactin up. A testosterone dose reduction might help some; enhanced by below-average SHBG, your free testosterone is higher than necessary. However, I'm pretty sure the hCG is throwing off your estradiol balance. I had the same problem. Your rate of aromatization is 0.75% (6.46 ng/dL E2 / 867 ng/dL T). The normal range is more like 0.3-0.6%.

A trial with cabergoline would be a simple way to verify that prolactin is part of the issue. But it's not a great long-term solution. It's one more parameter to juggle, and it can have side effects.
 
Yes it's plausible. TRT as incredibly subjective and individual. But few truths seem to be more consistently true, like prolactin kills erections as it increases post ejaculation.
 
It's likely that bringing down prolactin would improvce libido. The high estradiol is helping to push prolactin up. A testosterone dose reduction might help some; enhanced by below-average SHBG, your free testosterone is higher than necessary. However, I'm pretty sure the hCG is throwing off your estradiol balance. I had the same problem. Your rate of aromatization is 0.75% (6.46 ng/dL E2 / 867 ng/dL T). The normal range is more like 0.3-0.6%.

A trial with cabergoline would be a simple way to verify that prolactin is part of the issue. But it's not a great long-term solution. It's one more parameter to juggle, and it can have side effects.

Yes it's plausible. TRT as incredibly subjective and individual. But few truths seem to be more consistently true, like prolactin kills erections as it increases post ejaculation.
Many thanks guys - I was briefly given a tiny dose of cabergoline last year - although this was without an AI and before I was on HCG - it appeared to have a brief effect and then made little difference. I always seem to read high on prolactin in bloods but most doctors say 'it's a fickle hormone that fluctuates a lot - unless it was much much higher then unlikely to be an issue.'

The dose was 1/2 tab once a week for 8 weeks.
 
Many thanks guys - I was briefly given a tiny dose of cabergoline last year - although this was without an AI and before I was on HCG - it appeared to have a brief effect and then made little difference. I always seem to read high on prolactin in bloods but most doctors say 'it's a fickle hormone that fluctuates a lot - unless it was much much higher then unlikely to be an issue.'

The dose was 1/2 tab once a week for 8 weeks.
You could just drop your HCG and see if that makes a difference.
 
Could lowering those plausibly sort out the libido? I've had trt doctors tell me that patients with very high oestrogen can still have good libido.
Absolutely. Estrogen is the main driver of libido in men. Prolactin follows estrogen, unfortunately, and high prolactin is where all the problems lie. Most of the issues that guys associate with high E2 are usually due to having higher prolactin levels than their body prefers
 
PhillTheJuggler - Dump the HCG. You don't need it. Take it from me...I spent 3.5 years riding the "HCG Rollercoaster" and finally got off. The problem is the HCG. Yes, there were a couple good side effects (mainly larger penis and larger balls, maybe a little better orgasm. The side effects were bloat, lack of energy, moody, temper, anger, decreased sex drive, fuzzy thinking, etc.

I always suggest: Dump HCG for 2 weeks see how you feel. If you feel better don't take it. Want to increase sex drive, try 15 mg DHEA every morning or every other morning. That works for me.
 
PhillTheJuggler - Dump the HCG. You don't need it. Take it from me...I spent 3.5 years riding the "HCG Rollercoaster" and finally got off. The problem is the HCG. Yes, there were a couple good side effects (mainly larger penis and larger balls, maybe a little better orgasm. The side effects were bloat, lack of energy, moody, temper, anger, decreased sex drive, fuzzy thinking, etc.

I always suggest: Dump HCG for 2 weeks see how you feel. If you feel better don't take it. Want to increase sex drive, try 15 mg DHEA every morning or every other morning. That works for me.
Many thanks - that's not something I'd considered! I'll try that!
 
Unfortunately everyone is very different. As a start I would try to put this prolactin under control.

Me for example - I feel lethargic, apathy and almost no libido on enanthate and cypionate, sustanon is the only ester that works for TRT for me. But I think Im a bit extreme example. The point is that sometimes you just gotta experiment to find what will work for you.
 

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TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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