Link between Polycythemia and delayed orgasm?

[DFL]

I continue my search for reasons for delayed orgasms since starting TRT about 3 years ago. I also have to use either Levitra or Trimix whenever I have sex. I'm 54 and didn't have these issues before TRT. I'm wondering if any of you high Hematocrit people have noticed a link between that and delayed orgasm and/or sexual dysfunction?

I've tried many different protocols (Cyp and HCG only) but have never found anything that seems to work, except, sometimes, changes. For instance if I stop HCG I seem to get a brief period when things are easier, but it always comes back. Right now I'm on daily injections, 112 MG Cyp and 700iU HCG weekly, and things are not great in the orgasm department.

Today I gave blood 2 months late (5 months after last) and as I sat there I thought, could my Hematocrit problem be the link? I'm due for labs, but today my Hemoglobin was 19.2, same as my last labs when my Hematocrit came back at 54.6.

I found this study that suggests a possible link between Polycythemia and sexual dysfunction: Sexual dysfunction common among patients with myeloproliferative neoplasms

 

[Systemlord]

When you gave blood did erections and orgasms improve? I doubt its the hematocrit and hemoglobin causing your issues because stopping the HCG would see a reduction in both and still issues remain.

This seems to be a complaint of men on TRT where sexual parameters improve only after dosing changes. I believe it has to do with your body prefering a natural daily variation in hormones.

 

[DFL]

I never actually stopped HCG completely for more than around 1.5 weeks, but I did reduce from 1000iu weekly to 500iu with no long term improvement. I will see how this donation works out. It is extremely hard to track everything with so many variables. I do try to give every change at least 6-8 weeks, but I still haven’t found a solution. And I suspect there may not be one, but I’ll keep trying.

 

[bluerage]

I've noticed I have a harder time achieving an orgasm with trimix vs using nothing. I think sensitivity is higher without trimix.

 

[ed031561]

Wait, is this correct? " Right now I'm on daily injections, 112 MG Cyp"?? That would be over 700mg /wk of test cyp. Who prescribed that for you? That's cycle dosage not hrt. What is your estrogen level? And what is your total test, free and bio available test levels? For me personally, I have never seen any benefit from hcg. One doctor put me on it and my total test level hit 6,000! didn't feel any different though. How is your blood pressure?

 

[xcpatr922]

I've noticed I have a harder time achieving an orgasm with trimix vs using nothing. I think sensitivity is higher without trimix.

feels the same.

 

[Systemlord]

I can confirm high hematocrit decreased my penis size especially when not erect. I notice this 2 days after getting a phlebotomy do to my hematocrit being 57%.

 

[DFL]

I never actually stopped HCG completely for more than around 1.5 weeks, but I did reduce from 1000iu weekly to 500iu with no long term improvement. I will see how this donation works out. It is extremely hard to track everything with so many variables. I do try to give every change at least 6-8 weeks, but I still haven’t found a solution. And I suspect there may not be one, but I’ll keep trying.

Wait, is this correct? " Right now I'm on daily injections, 112 MG Cyp"??

No, "daily injections, 112 MG Cyp and 700iU HCG weekly." Last labs at trough were:
Total T: 477
Free T: 24.7 (7.2-24)
Estradiol Sensitive: 22.6

Those numbers were on 100MG Test Cyp and 1,000iu HCG weekly, dosing half of those numbers twice per week.

 

[DFL]

When you gave blood did erections and orgasms improve? I doubt its the hematocrit and hemoglobin causing your issues because stopping the HCG would see a reduction in both and still issues remain.

This seems to be a complaint of men on TRT where sexual parameters improve only after dosing changes. I believe it has to do with your body prefering a natural daily variation in hormones.

Orgasms have not improved after donation 10 days ago.

 

[DFL]

I've noticed I have a harder time achieving an orgasm with trimix vs using nothing. I think sensitivity is higher without trimix.

Trimix definitely makes orgasm more difficult for me. Vardenafil works best but time is limited. When I want unlimited time without having to worry about it there is no substitute for Trimix.

 

[sammmy]

The fact that your delayed orgasm improves only for a short period after you change your protocol, suggests that the issue lies in neurotransmitters and their cell neuroreceptors.

A similar phenomenon is the so called "honeymoon period", which is the first 2 weeks after you start TRT and your sexuality gets a huge boost. However, later the neuroreceptors sense a higher level of neuroactive compounds so the neuroreceptors downregulate (the body tries to maintain homeostasis) and the effect is lost.

Unfortunately, contemporary medicine does not have a good handle on boosting orgasmic ability. General guidelines are to take drugs that act on the dopamine receptors (dopamine agonists) or boost dopamine production or hit specific serotonin receptors that support orgasm - 5-HT1A receptor agonists like buspirone.

You could also measure your prolactin and reduce it if it is high. Nasal oxytocin an hour before sex is another thing to try.

 

[DFL]

The fact that your delayed orgasm improves only for a short period after you change your protocol, suggests that the issue lies in neurotransmitters and their cell neuroreceptors.

A similar phenomenon is the so called "honeymoon period", which is the first 2 weeks after you start TRT and your sexuality gets a huge boost. However, later the neuroreceptors sense a higher level of neuroactive compounds so the neuroreceptors downregulate (the body tries to maintain homeostasis) and the effect is lost.

Unfortunately, contemporary medicine does not have a good handle on boosting orgasmic ability. General guidelines are to take drugs that act on the dopamine receptors (dopamine agonists) or boost dopamine production or hit specific serotonin receptors that support orgasm - 5-HT1A receptor agonists like buspirone.

You could also measure your prolactin and reduce it if it is high. Nasal oxytocin an hour before sex is another thing to try.

Really interesting. I think that makes the most sense of anything I've heard. If this is the case, is it likely stopping TRT would eventually allow a return to normal? I started to go off once and lasted two weeks before depression started getting worse.

I'll look into your suggestions, thank you.

 

[sammmy]

The only way to know is to try stopping TRT for a while and see if your orgasmic ability restores. That will take months.

You indicated that you didn't have orgasmic issues before TRT but just because they started after TRT may be a time coincidence and does not prove cause and effect. You may have gotten some neurologic damage or neurotransmitter imbalance at that time, unrelated to TRT.