Low progesterone? Frustrated. Thinking of pulling the plug on TRT for good.

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antelopers

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I had labs done recently. I ran progesterone for the first time in years. All of my labs were relatively good, but my progesterone was completely undetectable, <0.1.
 
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Defy Medical TRT clinic doctor
If you're really thinking about stopping trt, what stopping you from trying HCG? Personally I'm a big fan of HCG. I've been injected now for 5 and 1/2 years, I wouldn't think of doing trt without it.
 
If you're really thinking about stopping trt, what stopping you from trying HCG? Personally I'm a big fan of HCG. I've been injected now for 5 and 1/2 years, I wouldn't think of doing trt without it.
I've tried it many times. I get a slight libido boost for a week or two followed by high estrogen, side effects like gynecomastia, etc. I've never been able to restore that "drive" to actually want sex, and if I'll be able to perform is a crapshoot.
 
Correct me if I am wrong, but as opposed to most hormones, progesterone is easily absorbed in pill form. My wife is on HRT, and that is the only one she takes orally. I realize you don't want to manage a bunch of prescriptions, but that one would be pretty easy. Assuming your doctor gets the dosing correct etc.
 
I wish I could just tell you the protocol that's going to make things work. But it's never that easy, is it? Instead all I can tell you is that what's really improved my quality of life is trying to mimic normal levels of hormones as much as possible, including neglected ones such as GnRH. It has resulted in a ridiculously complex protocol, but results are good enough to make it worthwhile. Part of the complexity is because I have to replace quite a few hormones; e.g. I have some indications from hCG use that my endogenous testosterone production will be inadequate regardless. Whereas you, at 25 years younger, have greater potential for normal natural production of most things.

So anyway, if I were 33 and feeling adventurous I would be interested in trying kisspeptin monotherapy. It might still be pretty tedious to test, requiring multiple small daily injections. But if the hormonal problems originated upstream of there then kisspeptin should make everything downstream act normally: GnRH, LH, FSH, T, E2. If the results were good then it would be worth exploring the use of an infusion pump. If kisspeptin didn't work out then I'd go on down to GnRH and do the same thing. I know, you're thinking this still all sounds too complicated. But you're way too young to spend the rest of your life feeling crappy.
 
I wish I could just tell you the protocol that's going to make things work. But it's never that easy, is it? Instead all I can tell you is that what's really improved my quality of life is trying to mimic normal levels of hormones as much as possible, including neglected ones such as GnRH. It has resulted in a ridiculously complex protocol, but results are good enough to make it worthwhile. Part of the complexity is because I have to replace quite a few hormones; e.g. I have some indications from hCG use that my endogenous testosterone production will be inadequate regardless. Whereas you, at 25 years younger, have greater potential for normal natural production of most things.

So anyway, if I were 33 and feeling adventurous I would be interested in trying kisspeptin monotherapy. It might still be pretty tedious to test, requiring multiple small daily injections. But if the hormonal problems originated upstream of there then kisspeptin should make everything downstream act normally: GnRH, LH, FSH, T, E2. If the results were good then it would be worth exploring the use of an infusion pump. If kisspeptin didn't work out then I'd go on down to GnRH and do the same thing. I know, you're thinking this still all sounds too complicated. But you're way too young to spend the rest of your life feeling crappy.
Appreciate that. I haven't seen anything about people being successful with kisspeptin, do you know of anyone it works for? I also thought it was recently banned from production in compounding pharmacies.

I'm thinking about making an appointment with defy and explaining all of this in excruciating detail and asking them to treat me like I'm a brand new patient, or if they would advise me coming off completely, or using something like you recommended.

Like you said, I'm way, way, way too young to be feeling like this, TRT or not. For a lot of guys, every protocol works, some better than others. For those of us where nothing works, there has to be something else we're missing. Maybe it's the gnrh like you described.
 
My understanding is that compounding pharmacies can no longer offer most peptides, and it's nothing against kisspeptin per se. I don't know anyone using kisspeptin yet, though there's a fair bit of promising research on it. It's somewhat telling that Peptide Sciences recently started offering it. This suggests that demand is increasing.

I expect GnRH therapy is a little too cutting edge for Defy, but I'd be happy to be wrong about that. At least it is a proven treatment; it's just that its complexity limits its popularity. While I don't want to create unrealistic expectations, this is the best I've felt overall since well before starting TRT. It seems to have been accomplished mainly by replacing hCG with GnRH and enclomiphene. I'd also switched to an enanthate/propionate blend injected daily to create more realistic serum testosterone levels. It's still possible that daily GnRH added to a conventional TRT/hCG protocol would provide benefits. We really need some research to explore this, as that would be more practical than what's needed to stimulate endogenous production of LH and FSH.
 
how long did you try Pregnenolone for? what dose? was it a Slow Released? Pregnenolone capsule SR increased my Progesterone
 
My understanding is that compounding pharmacies can no longer offer most peptides, and it's nothing against kisspeptin per se. I don't know anyone using kisspeptin yet, though there's a fair bit of promising research on it. It's somewhat telling that Peptide Sciences recently started offering it. This suggests that demand is increasing.

I expect GnRH therapy is a little too cutting edge for Defy, but I'd be happy to be wrong about that. At least it is a proven treatment; it's just that its complexity limits its popularity. While I don't want to create unrealistic expectations, this is the best I've felt overall since well before starting TRT. It seems to have been accomplished mainly by replacing hCG with GnRH and enclomiphene. I'd also switched to an enanthate/propionate blend injected daily to create more realistic serum testosterone levels. It's still possible that daily GnRH added to a conventional TRT/hCG protocol would provide benefits. We really need some research to explore this, as that would be more practical than what's needed to stimulate endogenous production of LH and FSH.

I won’t speak for Dr. Saya, but I have seen a discussion on GnRH involving some compounding pharmacies and gonadorelin specifically, and that it is not a viable alternative to hCG. It is not intended for prolonged use, and patients will end up with a net suppressive effect over time with continued use of it. So, it’s not a matter of a cutting-edge treatment, it’s that GnRH isn’t a viable treatment at all for replacing hCG long-term in patients.

Kisspeptin was never approved for compounding or any use, and from what I have been told by employees at compounding pharmacies, it likely never will be. That certainly isn’t going to stop some from producing it anyway.

In the interest of safety, I personally would rather purchase a product from a compounding pharmacy than peptide sciences or blue sky. Just because those web sites say cGMP and “pure” doesn’t make it so. Anyone can write anything they want to sell something and there is no regulation or accountability. They do however label everything with “not for use in humans” to 1) not immediately paint a bullseye on themselves and 2) CYA, because they know they need it.
 
how long did you try Pregnenolone for? what dose? was it a Slow Released? Pregnenolone capsule SR increased my Progesterone
I tried pure encapsulations pregnenolone 60mg every night before bed for about 6 months (with dhea on a doctor's recommendation, even though my dhea isn't low). I don't believe it is a sustained release supplement, I also did not check my progesterone on it since at the time I wasn't even considering it an issue. What's your experience like with pregnenolone? Did it help you?
 
Libido is something I’ve never been able to
Figure out after 11 years of trt. No dose, protocol or concoction of meds has been able to correct or improve it. I don’t honestly believe there is a solution long term.
 
It is man. I’ve been on trt for nearly 11 years and since year 6 I’ve been nearly asexual but feel good otherwise. No matter what anyone says this is a very common experience with trt.
 
I have never considered progesterone important for men. When you get older the level drops to zero or near zero since the testicles stop producing the little bit they make in earlier post pubertal life.
From what I can tell the low or no progesterone levels cause nose and ear hair to grow immensely. If that is true then the natural T with some P gives typical male hair growth on the body, then when P stops the nose and ears excel in hair growth.
I have worked in men's health for just over 10 years and have taken TRT for just over 4 years. I never tested my P levels but once. I did once take P lozenges of 50mg a day to make up for the cessation of my own zero level- but I only did that a few months since I could tell no difference in anything.
Don't ever take prostate drugs since they will severely diminish erections and make ejaculation all but impossible. Even if you take them a short time, if you ever recover it will be more than 18 months from last dose of any of them-they are killers for sex performance.
I have used pellets which I consider imprecise for dosing; injections which I consider variable in absorption depending on the muscle condition and use of the muscle during the absorption phase; and cream which I have now used for about 3 years. Daily application of 1 gram of 20 percent cream, applied in 2 weeks rotations to areas with little hair. I have also recently conducted an experiment at our office with myself and another employee by applying to the scrotum daily for 3 weeks. My T level with cream is about 750 but scrotal it jumped to 1544. The other party did similarly. I did notice more libido and stronger erections, and oily skin and pimples which means T was a little too high for me.
You need to consider a trial of cream, applied as ½ gram or 2 clicks to the scrotum daily for 6 weeks minimum. Forget about the P. And, you are having some mental defeat issues due to the decreased erections, which is another matter to deal with.
I hope this is of some help to you and any others who have this issue.
 
It is man. I’ve been on trt for nearly 11 years and since year 6 I’ve been nearly asexual but feel good otherwise. No matter what anyone says this is a very common experience with trt.
What T levels were you running and how did you determine that the level was the best level for you?
 
I have never considered progesterone important for men. When you get older the level drops to zero or near zero since the testicles stop producing the little bit they make in earlier post pubertal life.
From what I can tell the low or no progesterone levels cause nose and ear hair to grow immensely. If that is true then the natural T with some P gives typical male hair growth on the body, then when P stops the nose and ears excel in hair growth.
I have worked in men's health for just over 10 years and have taken TRT for just over 4 years. I never tested my P levels but once. I did once take P lozenges of 50mg a day to make up for the cessation of my own zero level- but I only did that a few months since I could tell no difference in anything.
Don't ever take prostate drugs since they will severely diminish erections and make ejaculation all but impossible. Even if you take them a short time, if you ever recover it will be more than 18 months from last dose of any of them-they are killers for sex performance.
I have used pellets which I consider imprecise for dosing; injections which I consider variable in absorption depending on the muscle condition and use of the muscle during the absorption phase; and cream which I have now used for about 3 years. Daily application of 1 gram of 20 percent cream, applied in 2 weeks rotations to areas with little hair. I have also recently conducted an experiment at our office with myself and another employee by applying to the scrotum daily for 3 weeks. My T level with cream is about 750 but scrotal it jumped to 1544. The other party did similarly. I did notice more libido and stronger erections, and oily skin and pimples which means T was a little too high for me.
You need to consider a trial of cream, applied as ½ gram or 2 clicks to the scrotum daily for 6 weeks minimum. Forget about the P. And, you are having some mental defeat issues due to the decreased erections, which is another matter to deal with.
I hope this is of some help to you and any others who have this issue.
Thanks a lot for sharing. I tried the cream for a while and while erections were somewhat improved, it still did not give me a libido at all. I'm going to give defy a call sometime soon for a consultation and see what they recommend.
 
I won’t speak for Dr. Saya, but I have seen a discussion on GnRH involving some compounding pharmacies and gonadorelin specifically, and that it is not a viable alternative to hCG. It is not intended for prolonged use, and patients will end up with a net suppressive effect over time with continued use of it. So, it’s not a matter of a cutting-edge treatment, it’s that GnRH isn’t a viable treatment at all for replacing hCG long-term in patients.
...
This is a garbled interpretation. Gonadorelin is bio-identical to GnRH. Natural men function by producing GnRH pulses for most of their lives. That, in effect, is extremely prolonged use. The kind of "prolonged use" you refer to as causing suppression is actually a continuous infusion of GnRH, rather then the intermittent pulses required by our bodies. This is just something described in research; it's not a treatment. It becomes a treatment intended to cause HPTA suppression when longer-lived GnRH analogs such as triptorelin are used. On the flip side, pulsed doses of gonadorelin are an approved treatment for male hypogonadism; they are proven to normalize the gonadotropins and testosterone. The need for an infusion pump is what limits its appeal. I have demonstrated that multiple daily manual injections of gonadorelin can function as a replacement for hCG, with other possible benefits. This will not be practical for most, but it absolutely works.
 
Thanks a lot for sharing. I tried the cream for a while and while erections were somewhat improved, it still did not give me a libido at all. I'm going to give defy a call sometime soon for a consultation and see what they recommend.
I expect Defy will not have anything significant for you to do since you have already done all they offer.
 
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