Decreasing TRT dose leading to low libido

[jamesinla]

Hey guys. First post on this forum.

I have been on TRT for a little over 2 years now. Here is my protocol:

Test Cyp IM 250mg (125mg E3.5D)
Arimidex 0.25mg EOD
HCG 500IU SQ 3x a week
Cialis 5mg Daily

Latest Bloodwork on trough day:

TT: 1490 ng/dL
FT: 24ng/dL
Estradiol (sensitive): 20pg/ml
SHBG: 24nmol/L
Prolactin: 4.4ng/ml



I recently decided that 250mg of Test a week is probably too much for TRT. Some people may even consider it to be a cycle. So I decided to try lowering my dose to 200mg a week (which is typically the max a Dr will prescribe for TRT).

About a week or two after lowering my dosage, I noticed a decline in my libido. I used to get rock hard erections, and wanted to have sex every day. But now I barely feel horny at all. I can pull it off, if I really concentrate, but the urge is no longer there. And it is not as satisfying.

I also lowered my arimidex dosage from 0.25mg EOD down to 0.2mg EOD to adjust for the lower Testosterone dosage, and to prevent E2 crash.

Have I been enjoying such a high libido for the past 2 years due to being on so much Test? Will I ever feel horny being on a lower T dosage, now that my mind/body was on such a high dosage for such a long time? Does it take time to adjust?

Any advice/insight would be much appreciated.

 

[Abuser200]

dont listen to anyone saying 250mg is to much. Its all about symptom resolution. If you have symtoms returning on 200mg, then simply go back to 250mg.. there was nothing wrong with your numbers !

 

[Goel]

Drop the AI from your protocol

 

[madman]

Hey guys. First post on this forum.

I have been on TRT for a little over 2 years now. Here is my protocol:

Test Cyp IM 250mg (125mg E3.5D)
Arimidex 0.25mg EOD
HCG 500IU SQ 3x a week
Cialis 5mg Daily

Latest Bloodwork on trough day:

TT: 1490 ng/dL
FT: 24ng/dL
Estradiol (sensitive): 20pg/ml
SHBG: 24nmol/L
Prolactin: 4.4ng/ml



I recently decided that 250mg of Test a week is probably too much for TRT. Some people may even consider it to be a cycle. So I decided to try lowering my dose to 200mg a week (which is typically the max a Dr will prescribe for TRT).

About a week or two after lowering my dosage, I noticed a decline in my libido. I used to get rock hard erections, and wanted to have sex every day. But now I barely feel horny at all. I can pull it off, if I really concentrate, but the urge is no longer there. And it is not as satisfying.

I also lowered my arimidex dosage from 0.25mg EOD down to 0.2mg EOD to adjust for the lower Testosterone dosage, and to prevent E2 crash.

Have I been enjoying such a high libido for the past 2 years due to being on so much Test? Will I ever feel horny being on a lower T dosage, now that my mind/body was on such a high dosage for such a long time?

Any advice/insight would be much appreciated.

Test Cyp IM 250mg (125mg E3.5D)
Arimidex 0.25mg EOD


Horrible protocol!

Way too high a dose for trt as you can clearly see that your trough TT 1490 ng/dL is absurdly high let alone your FT would be absurdly high.....much higher than the 24 ng/dL you posted as your SHBG is only 24 nmol/L let alone e2 would be through the roof but as you can see yours is far from high due to controlling it with the use of an AI.

Top it all off that your peak TT/FT/e2 levels will be much higher!

Bet your trough FT is well over 40 ng/dL with a whopping TT 1490 ng/dL and SHBG 24 nmol/L.

Hard to believe you stayed on such a dose for 2 years.

Would have been more sensible to lower your overall weekly dose and hopefully drop the AI.

FT 5-10 ng/dL would be considered low.

FT 16-31 ng/dL is considered healthy.

Most men will do well having FT 20-30 ng/dL.

Some may run slightly higher levels as it comes down to the individual and where they may feel best.

Highly doubtful anyone would need a trough FT 50-60 ng/dL to reap the beneficial effects of trt.

Too many get caught up in the more T is better mentality let alone have no idea how things work.

Most men on trt are injecting 100-200 mg/week (high-end) and can easily achieve a healthy let alone high TT/FT level on such dose.

Believe it or not, some are injecting <100 mg/week and will still be able to achieve a healthy TT/FT level.

Sure some men may need doses on the higher end but it is far from common let alone most would never need such a dose to achieve a healthy FT level.

Yes, there may be some outliers who use slightly more than 200 mg/week but this is very rare.




About a week or two after lowering my dosage, I noticed a decline in my libido.

Keep in mind many fail to realize that when starting trt or tweaking a protocol (dose T/injection frequency) that hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks when using TC/TE) and it is common for many during this transition to experience what we call the honeymoon period where there may be a strong increase in libido/erections and overall euphoric feeling due to increasing T levels/dopamine.

Unfortunately, this is temporary and short-lived for most as the body will eventually adjust.

It is also very common for many men to experience ups/downs in energy/mood/libido/erections/recovery during the transition as the body is trying to adjust which can be very misleading.

Even then do understand that once blood levels have stabilized (4-6 weeks) it will take another 2-3 months for the body to fully adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

When looking at the big picture the first 4-6 weeks is very misleading for most!

 

[madman]

dont listen to anyone saying 250mg is to much. Its all about symptom resolution. If you have symtoms returning on 200mg, then simply go back to 250mg.. there was nothing wrong with your numbers !

Its all about symptom resolution

Indeed and unfortunately most running absurd levels have never tried a lower dose let alone never given a lower dosed protocol a fighting chance!

You know the part I have stressed numerous times on the forum here that many fail to understand when it comes to using exogenous testosterone:


Keep in mind many fail to realize that when starting trt or tweaking a protocol (dose T/injection frequency) that hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks when using TC/TE) and it is common for many during this transition to experience what we call the honeymoon period where there may be a strong increase in libido/erections and overall euphoric feeling due to increasing T levels/dopamine.

Unfortunately, this is temporary and short-lived for most as the body will eventually adjust.

It is also very common for many men to experience ups/downs in energy/mood/libido/erections/recovery during the transition as the body is trying to adjust which can be very misleading.

Even then do understand that once blood levels have stabilized (4-6 weeks) it will take another 2-3 months for the body to fully adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

When looking at the big picture the first 4-6 weeks is very misleading for most!




If you have symtoms returning on 200mg, then simply go back to 250mg..

Horrible advice he just f**King lowered his dose 2 weeks ago.

*About a week or two after lowering my dosage, I noticed a decline in my libido.




there was nothing wrong with your numbers !

Guess you forgot the part that he is running 1500 ng/dL trough levels and with an SHBG of 24 nmol/L which is far from high his trough FT level would be through the roof.....much higher than the 24 ng/dL he posted.

You should very well know from being on here long enough that although TT is important to know FT is what truly matters as it is the active unbound fraction of testosterone responsible for the positive effects.

To top it all off that unfortunately when it comes to FT most are using/rely on piss-poor assays which are inaccurate and many have no clue where their FT level truly sits which is much higher than most would think.

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard equilibrium Dialysis or Ultrafiltration (next best).

Guess you also forgot to ask him where his RBCs/hemoglobin/hematocrit sit on such protocol.

Sure symptom relief is what truly matters but where your TT/FT levels truly sit on such protocol (dose T/injection frequency) is critical to know let alone the impact it may have on overall blood markers!

 

[jamesinla]

Drop the AI from your protocol

I am prone to gyno. I started to develop a chest that did not appear like a man’s chest, and I developed some of that rubbery mass behind my nipple. My E2 was as high as 41 pg/ml at one point. So I had to add the AI.

 

[DixieWrecked]

So drop your dose and drop your AI. The idea is to find the dose that doesn't require an AI and you feel good at. If you don't like how your chest looks, get the surgery.

 

[Starplex]

Similar to you I was on 250mg/ml for about 5 years. And yes Madman blasted me too. However, I will say I felt great (no AI), and all my health numbers were green. My problem was super high libido, to the point where it was causing issues since my wife is perimenopause. I also didn't like my higher hemocrit values, but was still managing.

Thus, I dropped my dose to 175 per week. I noticed a pretty substantial change in Libido. I still have a desire for sex and have no issues getting it up, but it's not all I think about and crave like before. I don't get angry when she says no like previously. And I've noticed no other substantial changes in mood or labs, etc with the lower dose. But for me it definitely effected Libido.

 

[jamesinla]

Similar to you I was on 250mg/ml for about 5 years. And yes Madman blasted me too. However, I will say I felt great (no AI), and all my health numbers were green. My problem was super high libido, to the point where it was causing issues since my wife is perimenopause. I also didn't like my higher hemocrit values, but was still managing.

Thus, I dropped my dose to 175 per week. I noticed a pretty substantial change in Libido. I still have a desire for sex and have no issues getting it up, but it's not all I think about and crave like before. I don't get angry when she says no like previously. And I've noticed no other substantial changes in mood or labs, etc with the lower dose. But for me it definitely effected Libido.

Thanks for sharing. I have also noticed that my libido is on the rather higher side. I think that it why I am resistant to lowering my dose. I enjoy the high libido. I have also gotten angry when my partner has told me no in the past. It has caused some issues in my relationship in the past, but I think I am better at managing the anger. We now have scheduled sex twice a week, and I just masturbate on the other days.

I guess I will see how the 200mg per week dosage goes for a while. I might consider lowering my dosage down to 175mg like you. I am worried about the long term affects of such high T levels. Hair loss? Prostate issues?

I feel great on the higher dosage, but may be wise to lower it a bit.

 

[madman]

Similar to you I was on 250mg/ml for about 5 years. And yes Madman blasted me too. However, I will say I felt great (no AI), and all my health numbers were green. My problem was super high libido, to the point where it was causing issues since my wife is perimenopause. I also didn't like my higher hemocrit values, but was still managing.

Thus, I dropped my dose to 175 per week. I noticed a pretty substantial change in Libido. I still have a desire for sex and have no issues getting it up, but it's not all I think about and crave like before. I don't get angry when she says no like previously. And I've noticed no other substantial changes in mood or labs, etc with the lower dose. But for me it definitely effected Libido.

Blasted.....what for someone finally kicking some reality his way!

Did you miss the part where he stated.....About a week or two after lowering my dosage, I noticed a decline in my libido.

Unfortunately, he any many have no clue how this works when it comes to the use of exogenous T let alone in many cases are clueless where their FT truly sits.

Burn post #5 in your dome..... a perfect example of horrible advice and yes that is from a long-time member of the forum!


Abuser200
dont listen to anyone saying 250mg is to much. Its all about symptom resolution. If you have symtoms returning on 200mg, then simply go back to 250mg.. there was nothing wrong with your numbers !

He is clearly clueless as to the OP just f**King lowered his dose 2 weeks ago let alone with an absurd trough TT 1490 ng/dL (twice weekly injections) and SHBG 24 nmol/L his trough FT would be through the roof and much higher than the 24 ng/dL he posted. Top it all of that he is trying to manage what would have been sky-high e2 levels by jumping on an AI.





*This should be hammered into every patient's head before starting trt!

Keep in mind many fail to realize that when starting trt or tweaking a protocol (dose T/injection frequency) that hormones will be in flux during the weeks leading up until blood levels stabilize (4-6 weeks when using TC/TE) and it is common for many during this transition to experience what we call the honeymoon period where there may be a strong increase in libido/erections and overall euphoric feeling due to increasing T levels/dopamine.

Unfortunately, this is temporary and short-lived for most as the body will eventually adjust.

It is also very common for many men to experience ups/downs in energy/mood/libido/erections/recovery during the transition as the body is trying to adjust which can be very misleading.

Even then do understand that once blood levels have stabilized (4-6 weeks) it will take another 2-3 months for the body to fully adapt to those new levels and this is the critical time period when one should gauge how they truly feel overall regarding relief/improvement of low-t symptoms.

When looking at the big picture the first 4-6 weeks is very misleading for most!




What I stated above numerous times on the forum is one of the main reasons why so many struggle on trt.....a true SHIT SHOW to say the least!

 

[madman]

Thanks for sharing. I have also noticed that my libido is on the rather higher side. I think that it why I am resistant to lowering my dose. I enjoy the high libido. I have also gotten angry when my partner has told me no in the past. It has caused some issues in my relationship in the past, but I think I am better at managing the anger. We now have scheduled sex twice a week, and I just masturbate on the other days.

I guess I will see how the 200mg per week dosage goes for a while. I might consider lowering my dosage down to 175mg like you. I am worried about the long term affects of such high T levels. Hair loss? Prostate issues?

I feel great on the higher dosage, but may be wise to lower it a bit.

Just for you my man.

Think long and hard on this one.

If you are not willing to give the lower dose protocol a fighting chance then save yourself the misery and stay amped up if that is where you feel best!

Canadian Urology Guideline on Testosterone Replacement

Canadian Urological Association clinical practice guideline on testosterone deficiency in men: Evidence-based Q&A (2021) Ethan D. Grober, MD; Yonah Krakowsky, MD; Mohit Khera, MD; Daniel T. Holmes, MD; Jay C. Lee, MD; John E. Grantmyre, MD; Premal Patel, MD; Richard A. Bebb, MD; Ryan...

www.excelmale.com

Overlooked let alone misunderstood by many!


26.What is a reasonable timeline to begin to observe improvements in the signs and symptoms of testosterone deficiency?

*Following the initiation of testosterone therapy, serum concentrations of testosterone are known to correct earlier than the symptomatic, structural, and metabolic signs associated with TD.76,77 As such, patients should be counseled that symptom response will not be immediate. Expectations for treatment response should be established with each patient. Patients can anticipate improvements in many of the common symptoms of TD (libido, energy levels, sexual function) after 3 months of treatment or longer. Metabolic and structural (body composition, muscle mass, bone density) changes may take upwards of 6-months. 77 In addition, patients should be counseled that diet and exercise in combination with testosterone therapy are recommended for body composition changes.

*Appreciating this pattern of response to testosterone therapy is fundamental when determining the impact of treatment and the appropriate timing of follow-up evaluations while on therapy. For example, if patients undergo a symptom review and measurement of testosterone levels too early (< 3 months), it may lead both physicians and patients to conclude that the treatment has not been impactful (i.e. normal levels of testosterone without symptomatic/structural/metabolic benefit). However, if the same assessment was scheduled 3-6 months after the initiation of therapy, the clinical response tends to be more reflective of normalized levels of serum testosterone.

 

[madman]

*Following the initiation of testosterone therapy, serum concentrations of testosterone are known to correct earlier than the symptomatic, structural, and metabolic signs associated with TD.


This would also apply to anyone already on trt that is tweaking a protocol (dose T/injection frequency).

 

[M.J]

Just to add to this my first doctor recommended 250mg once weekly with ai he is very famous but I decided to go down now I am doing 75 once weekly.
Libido though is not good. Would I do the 250mg like he recommended ? I don’t think I would., but it would be interesting to know if it does make a difference if we go high.

 

[jamesinla]

Just to add to this my first doctor recommended 250mg once weekly with ai he is very famous but I decided to go down now I am doing 75 once weekly.
Libido though is not good. Would I do the 250mg like he recommended ? I don’t think I would., but it would be interesting to know if it does make a difference if we go high.

Maybe somewhere in between 250 and 75? 150 seems like a decent dosage. I’m still going to stick to 200 and see how things go in the next couple of months.

 

[madman]

Just to add to this my first doctor recommended 250mg once weekly with ai he is very famous but I decided to go down now I am doing 75 once weekly.
Libido though is not good. Would I do the 250mg like he recommended ? I don’t think I would., but it would be interesting to know if it does make a difference if we go high.

Yeah, the one that jacks his patients up on T from the get-go.....the same one that loves dishing out those AIs and keeping estradiol in that so-called magical range of 20-30.....LOL!

You have already hit high TT/FT levels on some of your previous protocols using much less T.

Like I stated in a previous thread of yours let alone many others on the forum:

You need to get out of the mindset of trying to chase this honeymoon period as it is temporary and short-lived.

Shut down of the HPTA most likely has a big impact.

Hate to burst your bubble if you think that having healthy testosterone levels let alone constantly fluctuating will result in a raging libido/killer erections.

There is so much more involved when it comes to libido/erectile function.

Having healthy testosterone levels is one piece of the puzzle.

Even then when it comes to trt and libido many tend to get caught up in thinking that it will be through the roof once they hop on trt and get to the point of so-called dialed in let alone cure any ED issues they may have.

When you find that happy place you should have a healthy libido not raging, savage, insane.

There are many men who will see an improvement in libido, others will continue to struggle, some may even end up worse off than before trt and some of the lucky ones will see a drastic improvement.

I think too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

 

[M.J]

Maybe somewhere in between 250 and 75? 150 seems like a decent dosage. I’m still going to stick to 200 and see how things go in the next couple of months.

I am reading the experts opinion in this forum and many say this is not the way to get libido. I am only two or one year experience in this forum so I would follow there opinion honestly.
Also I don’t think I can’t take higher than this otherwise blood donation and iron goes down etc.

 

[M.J]

Yeah, the one that jacks his patients up on T from the get-go.....the same one that loves dishing out those AIs and keeping estradiol in that so-called magical range of 20-30.....LOL!

You have already hit high TT/FT levels on some of your previous protocols using much less T.

Like I stated in a previous thread of yours let alone many others on the forum:

You need to get out of the mindset of trying to chase this honeymoon period as it is temporary and short-lived.

Shut down of the HPTA most likely has a big impact.

Hate to burst your bubble if you think that having healthy testosterone levels let alone constantly fluctuating will result in a raging libido/killer erections.

There is so much more involved when it comes to libido/erectile function.

Having healthy testosterone levels is one piece of the puzzle.

Even then when it comes to trt and libido many tend to get caught up in thinking that it will be through the roof once they hop on trt and get to the point of so-called dialed in let alone cure any ED issues they may have.

When you find that happy place you should have a healthy libido not raging, savage, insane.

There are many men who will see an improvement in libido, others will continue to struggle, some may even end up worse off than before trt and some of the lucky ones will see a drastic improvement.

I think too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

Yup he is the one
I am following you guys, been on this 75mg now for maybe 3 month. I will give this sometime before doing anything.

 

[Trip McNeely]

Yeah, the one that jacks his patients up on T from the get-go.....the same one that loves dishing out those AIs and keeping estradiol in that so-called magical range of 20-30.....LOL!

You have already hit high TT/FT levels on some of your previous protocols using much less T.

Like I stated in a previous thread of yours let alone many others on the forum:

You need to get out of the mindset of trying to chase this honeymoon period as it is temporary and short-lived.

Shut down of the HPTA most likely has a big impact.

Hate to burst your bubble if you think that having healthy testosterone levels let alone constantly fluctuating will result in a raging libido/killer erections.

There is so much more involved when it comes to libido/erectile function.

Having healthy testosterone levels is one piece of the puzzle.

Even then when it comes to trt and libido many tend to get caught up in thinking that it will be through the roof once they hop on trt and get to the point of so-called dialed in let alone cure any ED issues they may have.

When you find that happy place you should have a healthy libido not raging, savage, insane.

There are many men who will see an improvement in libido, others will continue to struggle, some may even end up worse off than before trt and some of the lucky ones will see a drastic improvement.

I think too many get caught up in expecting to feel great 24/7 once on trt as if testosterone is going to cure all that ails them.

Kind of interesting that I don't see his patients on this forum 24/7 complaining about low libido or not being dialed in.

 

[M.J]

Kind of interesting that I don't see his patients on this forum 24/7 complaining about low libido or not being dialed in.

My issue with his protocol is I will face major issues with hematocrit. Going in this circle of donating blood crashing my iron is something I don’t want at all. I really hope hematocrit don’t go up with my current protocol.
Plus I have tried going high is T “though not as high as his” and didn’t feel any good.

also even he mentioned that I will go through honey moon period. So don’t expect reaching honey moon period with his protocol as it’s temporary as he said.

 

[madman]

Kind of interesting that I don't see his patients on this forum 24/7 complaining about low libido or not being dialed in.

Absurdly high FT and estradiol within a tight range must be where it's at!

Stick around you will come across many that struggle with libido let alone ED.....average T, high T, absurdly high T.....e2 here e2 there.....you get the picture!