Libido - setting expectations

[HarryCat]

I didn't want to hijack marshall's thread but I wanted to ask about this.
I've been on TRT for 2 years. About 8 weeks ago I started sub-q injections after being on transdermals
9 months. I got a huge burst in libido and elimination of ED about a week after starting injections which then disappeared after a few days. This is the case with me whenever starting a new protocol after being off the previous protocol for a week or two. Right now my libido is zero, I have no interest in sex, Gene's NO stack has almost no effect, wife's complaining. Basically I'm worse off than before I ever started TRT, the usual case for me after being on TRT for a few of months.


I've read that libido is the last thing to return when starting TRT, but for me it has always been the first thing to return, only to disappear after a few days and then not return again, at least not in several months.


I added in HCG about 3 weeks ago. 500IU's per week, no effect. From what I've read it seems that HCG gives you a nice boost but is not the difference between zero sex drive and a decent sex drive. More like the difference between a decent sex drive and above average.


How long do I give the injections before moving on?

 

[Gene Devine]

Let me start out my saying that the big increase in libido and elimination of ED is a bit of a panacea for some men on TRT.

Libido is really very complex as it involves both the sympathetic and parasympathetic pathways.

It sound like from your experience you are sliding through a "sweet spot" where you get a good libido and no ED to where it returns again.

When was the last time you had complete BW done including extensive hormonal and thyroid work up?

What was your E2 level last BW and are you taking anything now to manage E2?

Can you watch porn, get an erection from it and have an orgasm from it?

 

[HarryCat]

When was the last time you had complete BW done including extensive hormonal and thyroid work up?

What was your E2 level last BW and are you taking anything now to manage E2?

My last complete workup was 2 years ago.
Thyroid is checked regularly, about 3-4 months ago I got that mostly dialed in with a medication and dosage that gives me pretty good results. I'm still tweaking the dosage a little trying to optimize.

When I was on transdermal T, I had gotten my T and FreeT levels near the top of the reference ranges for both. My E2 by the Labcorp sensitive test was 28. Now that I'm at a lower level for both T and FreeT and am doing injections I doubt my E2 is an issue, but I could have it checked.

Can you watch porn, get an erection from it and have an orgasm from it?

No, not for the past couple of weeks.

 

[Gene Devine]

If it's been two years since you last complete BW it's time.

In fact, at a minimum you should be checked every 12 months if dialed in and 6 months is even better.

Let's see what's going on as clearly something is amiss.

 

[HarryCat]

If it's been two years since you last complete BW it's time.

Do you have a recommended list of tests? I get my thyroid, VitD, testosterone levels checked, and I get a metabolic panel done with my annual physical, ferritin and iron were checked a few months ago. Not sure if prolactin would change over the course of 2 years, when I asked my doc about it at my last appt. he said he didn't think so.

 

[Gene Devine]

What you shout test for:

Total Testosterone
Bioavailable Testosterone (AKA “Free and Loosely Bound”)
Free Testosterone (if Bioavailable T is unavailable)
SHBG
DHT
Estradiol (specify “sensitive” assay for males)
Prolactin
Cortisol
Thyroid Panel
CBC
Comprehensive Metabolic Panel
Lipid Profile
PSA (age dependent)
IGF-1, IGFBP-3

 

[Cooper]

When I was on transdermal T, I had gotten my T and FreeT levels near the top of the reference ranges for both. My E2 by the Labcorp sensitive test was 28. Now that I'm at a lower level for both T and FreeT and am doing injections I doubt my E2 is an issue, but I could have it checked.

.

Numbers continued to be good with transdermal? If so why the switch to injections and are you feeling better overall with injections?

 

[HarryCat]

Numbers continued to be good with transdermal? If so why the switch to injections and are you feeling better overall with injections?

I wasn't feeling much of a benefit while on the transdermal. Thought that the injections might have a different profile of E2 and DHT and that could result in me feeling better. At this point I can say that I do not feel any different on injections as compared to transdermal, although I have not gotten my levels up as high as they were on the transdermal.