Low sex drive on hrt with blood work

[sour_patch]

I've had a really low sex drive lately which isn't normal for me,any thoughts or suggestions would be very much appreciated. I'm 30 now, when I was 17 I had brain cancer a "medulla blastoma" with brain surgery and a resection... 31 radiation treatments and 6 chemotherapy treatments. I've been on hormone therapy for the past 5 years. I'm currently taking 100mg testosterone a week and use hcg, cortef 15mg total a day divided in 3 doses, nature thyroid and florinef. My labs are posted below, and I have more labs coming up in 2 weeks as well. Was taking b12 injections before those labs were taken and cut back on 1/4 the dosage.

 

[CoastWatcher]

Welcome to Excelmale. It's a challenging health road you've had to travel. Did I miss it, or did you not run an estradiol (sensitive) test? Is it simply (I know nothing is simple) loss of libido, or are you dealing with erectile issues as well? This is the first time you've had this present itself?

 

[johndoesmith]

You seem to have multiple tests there, one with a testosterone level of 304, and one with 800 something.

I assume they were taken at different times, so you need to separate the tests by date.

Also when were these drawn relative to injection?

Sorry to hear about your cancer, you went through a lot.

Also, some of your CMP results are out of range, and I'm not exactly sure what it means in your case due to your complications.

 

[sour_patch]

I've not been aware of the (sensitive) estradiol test. Can get erections but no more morning wood and huge decline in wanting sex. I've had some other issues such as terrible sleep, excess fat around abdomen,being extremely tired, inability to lose fat and very minimal muscle gain but not sure if they are related. My sex drive has been going down hill for about a year and just started on hcg about a month ago which I think has helped a lot.. But would like to get morning erections back and have high sex drive back. I've had a ton of bloodwork done the past few months trying to get to the bottom of all this. I only posted the labs I thought might have been relevant but have plenty of other labs I can post if needed. My cholesterol, triglycerides and some other stuff is not in a healthy range. I saw a cardiologist recently who thought sleep apnea could be causing some of the problems so waiting for the results of my sleep study. If any specific lab results would help getting to the bottom of this let me know. I usually get my labs a week after injection. The main thing I noticed from previous labs is my shbg has gone done from 25 to 15.

 

[johndoesmith]

I've not been aware of the (sensitive) estradiol test. Can get erections but no more morning wood and huge decline in wanting sex. I've had some other issues such as terrible sleep, excess fat around abdomen,being extremely tired, inability to lose fat and very minimal muscle gain but not sure if they are related. My sex drive has been going down hill for about a year and just started on hcg about a month ago which I think has helped a lot.. But would like to get morning erections back and have high sex drive back. I've had a ton of bloodwork done the past few months trying to get to the bottom of all this. I only posted the labs I thought might have been relevant but have plenty of other labs I can post if needed. My cholesterol, triglycerides and some other stuff is not in a healthy range. I saw a cardiologist recently who thought sleep apnea could be causing some of the problems so waiting for the results of my sleep study. If any specific lab results would help getting to the bottom of this let me know. I usually get my labs a week after injection. The main thing I noticed from previous labs is my shbg has gone done from 25 to 15.

Okay, you didn't really answer my questions so it's hard to say much. You also added some confusion into this.

1. You have 5 pages listed up there, they don't seem to all be from the same blood draw. Organize them and give details to their conditions.

2. You said you USUALLY go one week after injection, does that mean day of injection but before injection? Do you sometimes go day 5? We need to know

3. Always post as many labs as you can.

4. Do you have ANY E2 results? Sensitive test is a must for any guy on TRT.

 

[sour_patch]

Okay, you didn't really answer my questions so it's hard to say much. You also added some confusion into this.

1. You have 5 pages listed up there, they don't seem to all be from the same blood draw. Organize them and give details to their conditions.

2. You said you USUALLY go one week after injection, does that mean day of injection but before injection? Do you sometimes go day 5? We need to know

3. Always post as many labs as you can.

4. Do you have ANY E2 results? Sensitive test is a must for any guy on TRT.

1. Sorry for the confusion, I had posted blood work from two different labs and did not mean to complicate things.. My apologies.. The labs posted below in the first three pictures are from 9-7-2016 and are my most recent labs.. 2. Usually I'll do my injection say Tuesday for example and I'll get my labs drawn 1 week after on Tuesday before I do my weekly injection 3. I will keep that in mind.4 All I have is the estrogen, total,serum which is posted below but I will be sure to get the sensitive test in 2 weeks when I get my new lab work.

 

[johndoesmith]

1. Sorry for the confusion, I had posted blood work from two different labs and did not mean to complicate things.. My apologies.. The labs posted below in the first three pictures are from 9-7-2016 and are my most recent labs.. 2. Usually I'll do my injection say Tuesday for example and I'll get my labs drawn 1 week after on Tuesday before I do my weekly injection 3. I will keep that in mind.4 All I have is the estrogen, total,serum which is posted below but I will be sure to get the sensitive test in 2 weeks when I get my new lab work.

Okay cool. So you said usually you test 1 week after, why usually?

The other 2 labs in your main post, when were those taken? I think the total testosterone there is 304?

You have a really nice trough, 800 something after a week, with low SHBG is amazing! I almost think it might be a bit high of a dose, I almost can't believe the trough with your 15 shbg.

Unfortunately these tests aren't enough but to tell you to donate blood! The total estrogen test is even more useless than the standard E2 test is.

you also don't have prolactin, DHT, or sensitive E2, which all have roles in libido so there's no way to really understand what is going on.

 

[TMI]

you also don't have prolactin, DHT, or sensitive E2, which all have roles in libido so there's no way to really understand what is going on.

How would having test results for prolactin, DHT, or sensitive E2 clarify what is going on?

Please be specific, thank you.

 

[CoastWatcher]

How would having test results for prolactin, DHT, or sensitive E2 clarify what is going on?

Please be specific, thank you.

Elevated prolactin and estradiol can tank libido. Cabergoline can typically bring elevated prolactin into range. Dosage manipulation or the use of an AI is a reasonable response to estradiol that is too high. It should be noted that if estradiol falls too low, an all to common possibility, one can experience problems with libido, too. Finally, DHT can impact libido and is often overlooked (though here at EM most successful protocols have incorporated regular DHT monitoring as a standard lab test).