Hey, 27 with mumps orchitis

[Sbouza]

Hello

Sbouza here from Quebec, Canada, 27 years old male.

3 years ago, I suffered from mumps as an adult. Mumps is a disease for which the majority of people are vaccinated against since the last 20th century. Unfortunately, I suffered a complication from mumps called epididimo-orchitis: inflammation of the balls and the epididymis.

The balls you know. But the epididymis are 6 meters long, very thin, highly convoluted small tubes that store sperm while they mature.

Although there is little data regarding the mumps - it is hard to find affected people nowadays - there are studies that have shown that the mumps virus attacks the Leydig cells of the testicles in mice. The Leydig cells are what secrete testosterone. Mumps complications such as epididymitis can also cause infertility.

This was been such a testing time for my balls, that to this day they ache... an exquisite dull ache. Especially the right one. Especially if I hit then against anything by accident.

At the time I was a very happy, highly productive and motivated person. I went to the gym often, I was in great shape. I love partying and doing stuff. I also having sex with my flatmate and with a girl at work. I masturbated frequently too, and had a great libido.

Unfortunately for me, this changed in a very drastic way after the mumps.

Now, I don't have as many friends as I use to because my old friends wanted to go out and do stuff and I... just didn't. And I don't particularly want to make new friends either. The reason is that I am fatigued even before I get out of the bed in the morning. So spending energy on socialising and sustaining relationships is too much.

It's really weird to be fatigued. It's not the same as being sleepy or depressed. I am not sleepy at all and I am not depressed. I just don't have the resources to do things. I not like muscle fatigue either - my muscles are not fatigued. It's hard to describe. It's the complete and total absence of any kind of excitement or motivation towards doing something. Mental and emotional lethargy.

Fatigue has affected every area of my life.

I have adapted nicely - all things considered to my fatigue. I have switched jobs from being a manager to being an engineer. When I come back home from work I do calming activities such as cooking, walking, reading and resting.

But, I can only read for so long before I get tired and feel like my brain is full.

Sexually, I have also changed. While I can get an erection. I certainly do not wake up with one - the notion is almost laughable. I have had sex once in the last 3 years and it was not a particularly good experience: very mechanical, boring, and lasted too long. A bit like my masturbation sessions which I practice a few times a week.

Basically my **** is really limp most of the time and my libido is useless. I can look at a women and think that she has beautiful features, but I am not attracted. And the ironical part is that this doesn't really bother me as much as it should. I do not have a shred of libido. I. Just. Don't. Care. Sex doesn't register with me.

Otherwise, I also put on quite a lot of weight - but I have successfully be losing that. And I'm also quite an irritable. And I have been getting the urinary problems that come with a large prostate.

As far as my testosterone goes. I have only done two tests. Once my total T came back at 140nmol/dl from a private lab, and another time came back at 460nmol/dl from the doctor's lab. My LH is high at 9IU/L. So it seems like I have primary hypogonadism from mumps orchitis.

Over the last three years, I have hoped that my condition would get better and I have been busy travelling a lot. However, now that I am not seeing any progress, I am going to take care of this problem.


I have started to read Nelson's book, along with TRT a Recipe for Success, and another book on TRT.

I am soon coming back to Quebec, and I am going to look for good doctors. I am first going to find a urologist to see if he can pick up anything that can be fixed with my balls - a cyst or scar tissue or something. I'm pretty much willing to have the right one removed at this point, if we think it will help T production or libido.

I am also going to look for a good TRT doctor. I have noticed that there seems to be a few specialised clinics in Ontario, but that there are no clinics in Quebec. If you have any recommendations on Quebec doctors, please please let me know.

I am also prepared to take care of my TRT myself. I would probably have to study up more on the topic. But I feel like this is a viable approach. I certainly do not feel like it is not worth the hassle to convince doctors to help me if they will not want to. I would much rather start the process myself, get back my energy, and then look for a doctor and basically tell him "This is what I have done, can we take it together from here?" But the ideal solution is to go with a doctor from the get-go.


Anyways, thanks for reading!

 

[Cataceous]

You guys who potentially have primary hypogonadism may be interested in a slightly different approach to treatment. Here's one of various posts I've made on the subject:

It would be useful to have measurements of SHBG and LH. The latter would give an indication as to whether you do have testicular insufficiency. The former can be used to calculate a better estimate of free testosterone than that inaccurate direct test you had. In any case, you appear to be hypogonadal and probably would benefit from some form of testosterone therapy.

What's frequently underappreciated about TRT are the widespread effects on many other hormones, which sometimes create additional problems. One way to mitigate this issue is to use a short-acting form of testosterone, such as testosterone nasal gel or troches. These forms of TRT aren't the most convenient, but they're a good place to start; they can help you determine if higher testosterone is beneficial with less of a long-term commitment.

If you are diagnosed with testicular insufficiency—primary hypogonadism—then be aware that it may be possible to dose your TRT in a way that minimizes the impact on other hormones. The technique involves starting with a low dose and increasing slowly while monitoring LH. In primary hypogonadism your LH is expected to initially be either high in-range or above. As the dose of testosterone is increased, LH should decrease. The idea is to find the dose that puts LH around the middle of the normal range. In this way you avoid the possible problems that occur when the HPTA is entirely suppressed.

Having residual sexual issues on TRT sometimes means the dose of testosterone is too high, which isn't necessarily related to other hormonal disruption. But having excessive testosterone along with HPTA shutdown increases the odds of side effects.

 

[Cataceous]

I have low SHBG and LH is normal, not elevated as in most cases for primary Hypogonadism. I react good on hCG but I changed to TRT, because I have cryonconservated sperm and I am expecting a child.

Do you have an AM total testosterone measurement to go with that SHBG? If you provide these two numbers then we can estimate free testosterone to get a better idea of your status. I assume that normal LH value was measured prior to TRT? Under conventional TRT it's expected to drop to low levels. What is body mass like? Lower SHBG can be associated with metabolic issues.

 

[Cataceous]

Before trt
Testosteron 2,85ng/ml
Shbg 21,4nmol/l
FAI 46%
LH 4,7 IU/l
BMI in the normal range. I am 1,83m and weigh around 80kg.
With hcg
Testo 6,5ng/l
...

Assuming normal albumin, Vermeulen calculated free testosterone is around 7 ng/dL, which is on the low side. The normal LH points towards secondary hypogonadism, as does the response to hCG. This would suggest brain mediation—hypothalamic or pituitary—rather than testicular insufficiency. Unfortunately this means you can't use dose-tuning with LH. What is your TRT protocol? Did you have more comprehensive testing to rule out other problem areas, thyroid, adrenals, CBC, CMP, etc.?

It's unfortunate that the illness may have cost you your marriage. However, it sounds like you'll be able to turn things around, at least as far as the sex hormones go. There are various things to try in the realm of TRT that may help to resolve your lingering symptoms.