Low Libido, Low SHBG Protocol HELP - LABS x3

[Robotics]

Has anyone dealt with something similar? Libido seems to be illusive and hard to find. I am a low SHBG and struggle with libido/erections. daily injector IM (9mg x 7 = 63 mg week)

The only time I have felt normal in that sense (libido) is usually when I am coming off TRT (for a week or two). Or randomly when off TRT for a select week or so.

I theorize that my E2 on TRT is too high even though my T is sufficient. I also feel anxiety and loss of Penis sensitivity and orgasm quality on TRT.

I am thinking of adding in 0.125mg 2x a week of arimidex, then 3x depending on how i feel/labs. To get my estradiol and free e2 down to match that set of labs where i felt some libido and decent erections(green column) to reach my Target (blue column).

Any Advice?



Estradiol is non-sensitive - sensitive is not available in my province.

​	Some Libido/ Decent Erections (off TRT)​	Bad libido/Erections (off TRT)​	Bad libido/so so Erections (on TRT)​	Target​	Range​
TT​	297​	320​	536​	536​	(230-835) ng/dl​
FT​	301​	276​	592​	592​	(175-700) pmol/L​
Estradiol​	23.43​	22.06​	39​	23.43​	(0-44) pg/ml​
SHBG​	16​	20​	16​	16​	(10-55) nmol/L​
​	​	​	​	​	​
Calculated Free E2​	0.67​	0.58​	1.14​	0.68​	​
Calculated TT/E2 Ratio​	12.7​	14.5​	13.7​	22.9​	​
Calculated FT/E2 Ratio​	12.8​	12.5​	15.2​	25.3​	​

Free E2 Calculator came from:
Spreadsheet for Calculating Free T & E2

 

[TLawyer]

Has anyone dealt with something similar? Libido seems to be illusive and hard to find. I am a low SHBG and struggle with libido/erections. daily injector IM (9mg x 7 = 63 mg week)

The only time I have felt normal in that sense (libido) is usually when I am coming off TRT (for a week or two). Or randomly when off TRT for a select week or so.

I theorize that my E2 on TRT is too high even though my T is sufficient. I also feel anxiety and loss of Penis sensitivity and orgasm quality on TRT.

I am thinking of adding in 0.125mg 2x a week of arimidex, then 3x depending on how i feel/labs. To get my estradiol and free e2 down to match that set of labs where i felt some libido and decent erections(green column) to reach my Target (blue column).

Any Advice?



Estradiol is non-sensitive - sensitive is not available in my province.

​	Some Libido/ Decent Erections (off TRT)​	Bad libido/Erections (off TRT)​	Bad libido/so so Erections (on TRT)​	Target​	Range​
TT​	297​	320​	536​	536​	(230-835) ng/dl​
FT​	301​	276​	592​	592​	(175-700) pmol/L​
Estradiol​	23.43​	22.06​	39​	23.43​	(0-44) pg/ml​
SHBG​	16​	20​	16​	16​	(10-55) nmol/L​
​	​	​	​	​	​
Calculated Free E2​	0.67​	0.58​	1.14​	0.68​	​
Calculated TT/E2 Ratio​	12.7​	14.5​	13.7​	22.9​	​
Calculated FT/E2 Ratio​	12.8​	12.5​	15.2​	25.3​	​

Free E2 Calculator came from:
Spreadsheet for Calculating Free T & E2

That's an incredibly narrow range on your E2. Doesn't really seem workable to to keep it within a 1 point range. What is your DHT level?

 

[Robotics]

That's an incredibly narrow range on your E2. Doesn't really seem workable to to keep it within a 1 point range. What is your DHT level?

DHT top of range due to my low shbg. The target E2, is just that, a target. I expect to get around it plus or minus a few points (low 20's).

 

[Cataceous]

It could be a useful experiment, but I'm sure you're aware of the multiple other variables that can differ between being on TRT and not, e.g. kisspeptin, GnRH, LH...

 

[swoops36]

You’ve got a lot of room to work with your dose. You might find you feel better with TT/FT higher even with lower SHBG. Your e2 looks fine, I wouldn’t add an AI to an already lower T protocol

 

[Robotics]

You’ve got a lot of room to work with your dose. You might find you feel better with TT/FT higher even with lower SHBG. Your e2 looks fine, I wouldn’t add an AI to an already lower T protocol

I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

 

[swoops36]

I see. I think your solution could be to see if your dose needs to be higher, or have you tried that before?

 

[TLawyer]

DHT top of range due to my low shbg. The target E2, is just that, a target. I expect to get around it plus or minus a few points (low 20's).

What do you consider top of the range? I wouldn't think it would be that high given where your TT is right now. For what it's worth, I am low SHBG (11-13) and use cream and injections. With cream, I hit total testosterone about 1,500 with a DHT of 144, and Defy is good with that. I level out with a total testosterone about 700 and DHT at 49 when the cream wears off.

 

[TLawyer]

I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

Have you ever had your prolactin levels tested?

 

[Robotics]

Have you ever had your prolactin levels tested?

Yes a while back. It was 11 (0-15 ug/L)

 

[Systemlord]

I feel high E symptoms even at 39. Anxiety, dull orgasms, loss of sensitivity.

I find that some men struggle to get an ideal T/E2 ratio on TRT, lowering your dosage might take you further away from your ideal T/E2 ratio, but raising your dosage may or may not do the trick.

 

[Robotics]

I find that some men struggle to get an ideal T/E2 ratio on TRT, lowering your dosage might take you further away from your ideal T/E2 ratio, but raising your dosage may or may not do the trick.

isn't another option adding a low dose AI? I have already tried lowering my dosage gradually down by 1mg a day increments, E2 came down but T values did as well as expected. How would raising my dosage help, the excess dht might offset the e2?

 

[AdamYoung]

Does testosterone cream reduces aromatising to estrogen n dht? Or the solution here is to use ester which doesnt aromatise. Can any experts way in please?

 

[Robotics]

@Dr Justin Saya MD This is an peculiar case. Would be great to get your view on it.