irritable_vowels
New Member
Ok fellas I have decided to post my detailed journey here for the benefit of anyone who may find themselves in a similar situation. It's long so be warned. Happy to answer questions on whatever I can for you.
Into my mid-20s I had still not needed to shave my face (having done so only in the hopes it would stimulate the growth that never came). At some point it hit me that I was behind my peers in my sexual conquests and interest. I’d had just one sexual partner to that time, a girlfriend of 5 years with whom I had split ways, and didn’t find myself really going after anyone else. Only in retrospect years later could I really understand how lackluster the sex was, because at the time it was both normal (I had no comparator except porn which I knew was not accurate) and because I didn’t feel disappointed by it.
The thing that ultimately pushed me to look into my testosterone, though, was my mood. I had been on antidepressants for years, but despite them always felt fatigued and emotionally volatile. I cried a lot. I would get to the college campus and be overwhelmed with sadness that was entirely illogical and sit and cry on a bench, or spend an entire weekend in bed burdened by a sense of worthlessness. Not helpful to my testosterone was that I started drinking heavily; it was the thing I gravitated toward for temporary relief, and as most of us know it does “work” in the short term at kicking the can down the road, but as most of us also should know by now alcohol worsens a hormonal imbalance.
At some point I became aware of the pain in my toe from all this can-kicking and decided there must be something “wrong” with me. Prior to that I had a depressive sense of guilt that my suffering was my own fault, my cross to bear, and that I was just destined to feel like shit for my life. It was a big change to allow myself to believe I might be able to feel better. I worked in the hospital setting at that point, night shifts, so had access to tons of resources that I dug into and all signs pointed to low T.
The thought of it made me embarrassed like it meant I wasn’t actually a man but a boy. It was embarrassing enough to keep me from asking my doctor about it unless I could really have some proof; low libido, depression, poor erections, no facial hair, and a skinny-fat type build (5’9, 165#) didn’t seem concrete enough to me. I ultimately found a place online that provides saliva testing for T. None of you should consider saliva testing for any kind of accurate numbers but as a screening method it was easy and cheap. I got those results back and my T was in the toilet, low enough that it seemed clear enough evidence to ask my doctor about.
Talked to my PCP and showed him the test I had done, he was quite nice and ordered a set of serum labs which told the same story – low T. I also had a bad cholesterol panel but normal thyroid. He unfortunately did not test estradiol, LH/FSH, SHBG, or others that would have been great as a baseline. He started me on a low dose of AndroGel and this gave me hope but it felt odd to be wiping on my dose of masculinity every morning. Unfortunately I lost insurance before noticing anything positive and had to start over a few months later with someone else.
I get a new primary through medical school. She was very patient and listened thoroughly to me and my concerns. She had me see the university’s urologist who was apparently a god in the world of men’s T treatment (John Barry, MD at OHSU). He took one look at me, listened to me talk about my issues, and told me I should start Clomid (clomiphene). It made sense to me – a medicine that made your body make its own T sounded so much better than injecting/wiping/pelleting/patching artificial manhood into/onto my body. I liked the idea of preserving fertility as well – keep in mind I was 26 at the time. With Dr Barry’s titration of the Clomid to 50mg daily I started to see results. I did not see those results until my T was up around 1100 (lab range was from 300-1080). Dr Barry reasoned that I have some mild androgen insensitivity which justified keeping it that high. I was having zero side effects, had balance with my estradiol, had resolution of my cholesterol, did not develop an elevated hematocrit, and felt amazing.
It was like my body was automatically converting my gut into muscle and sticking it onto my shoulders and pecs. I had the return of spontaneous erections that I had known only briefly in my adolescence. For the first time I had what felt like a truly masculine urge to fuck women, and I found myself feeling so much better with my mood and self-image that I actually pursued women and was successful. I no longer needed to take medicine to sleep. It seemed so easy. It seemed I had finally become the man I had been waiting for my whole life.
There were some interruptions along the way after Dr Barry asked my PCP to take over the medicine once I was stable. A covering PCP got a routine lab back and saw the T was high so told me to cut back the dose which I did, figured it was a good idea sometimes to make sure I was taking the minimum necessary, but felt my mood, energy, and libido all tank within a couple weeks or so. Returned to Dr Barry who resumed the 50mg dose and wrote me a letter to give to future doctors to keep them from messing with my treatment. I still have that letter in my fireproof safe.
A couple years later, after going from 1 to about 20 sexual partners through my pursuits, I had to move across the country. The PCP I picked up over on the east coast readily prescribed the Clomid 50mg a day which I continued in my year over there. I had 5 new partners in that year, finding myself in awe of the quality of woman I was able to meet and be with. The sex had become my primary objective and I was good at it. Note here that I am not trying to humblebrag – I will come back to this later.
In the last few months of that time, though (after being on the Clomid at full dose for about 2 ½ consistent years), I also started to get very emotionally volatile. Even with things going great – sex with apparently whomever I desired, making a solid 6 figures, new car, new experiences – I found myself sitting in my apartment considering how I could kill myself. I made plans to do it with my handgun. I didn’t try anything because ultimately I do have a logic in my head that is stronger than any of that shit could ever be over me, but that made the feelings no less disturbing or upsetting. At the time I wrote it off as homesickness and moved back to the west coast.
I arrive back west where I have a new job in a new community that is small. My new doctor there, despite my letter from Dr Barry and my voluminous medical records supporting my Clomid dose, said it was off-label and that I needed to see the only endocrinologist in town who was a woman. Feeling it would be easy to make my case with an expert I went ahead to that appointment, expecting to get the medication filled and be on my way.
However, this endocrinologist, who spoke English as a second language (relevant because I truly believe she had a hard time understanding accurately what I was saying about how I felt), did not like Clomid either. She said it was off-label and inappropriate. She also said my T was too high and that it was unsafe. I told her I did not respond well to lower doses and she told me I might need to see a psychologist for a gender identity problem. When she left the exam room to write me a woefully inadequate prescription for T cyp, I could literally hear her talking with the other women at the front desk and laughing about me. It was unbelievably maddening but also I got caught up on what she said about identity – not that I ever felt I was a woman, Jesus Fucking Christ that was upsetting – but I did wonder if I had some type of dysmorphia that meant I was not seeing the situation for what it was.
I became depressed even further, with my mood plunging in tandem with my T on the dose of T cyp 100mg every two weeks. I felt suicidal again. Let me emphasize something here, when I say suicidal I mean completely illogical and involuntary, unwanted intrusive thoughts about it being better to be dead than how I felt. I can assert to you it was in no way the kind of suicidal thinking that is needy, a cry for help, or indicative of some psychological weakness (I work in psychiatry now, I could recognize if that were the case and I have no reason to lie about it to you now). I don’t mean to disparage others who have had suicidal thoughts because I take those very seriously regardless of the context, but I want to emphasize for you reading here that I had these kind of thoughts emerge in a way that was very obviously directly related to my hormones.
I had nobody else to see in the area to talk to about my T situation. I kept with the endo’s prescription for T cyp which at best had my T up to mid-400s. I felt terrible. I called friends and family crying about all kinds of stuff. My work suffered. I tried to date but it was not going well. To get better care I drove over 2 hours to the nearest city and went to a “men’s clinic”. I knew the drill there, you go in and pay them cash and they give you T. I knew I needed something better than I had, though, and could not find a way to get the Clomid back, so hopped on the T bandwagon. The PA-C I met with had me start T cyp 200mg weekly with 1mg anastrozole, a common combo. Within a month I was roaring back, in fact feeling better than I had on the Clomid. All the benefits were there. My labs looked as they did when on Clomid, T around 1100.
In retrospect I believe my body’s response to the T changed over time. I found myself incredibly jealous of my girlfriend, an absolutely wonderful and trustworthy partner, getting to the point of paranoia about what she was doing when I was out of the house. I thought about putting cameras in my house to catch her with another dude. None of this was rational but it really hurt our relationship. Only looking back do I feel I can identify this was very likely during a time where my T levels were higher than they should have been.
A couple times I asked to try and return to Clomid, for sake of fertility, my shrunken testicles, and because I never liked the idea of injecting my masculinity. We tried two different strategies but neither worked; I can detail those separately. I returned to the T/anastrozole both times, but after the second try I definitely didn’t feel the same again.
Something had indeed happened to where my body was acting differently with the T; my levels were up above 1500 and my E was also high, and I felt my libido was suppressed until the end of every 7 day injection cycle. I pulled back on the T to see if I could find a balance. My sex drive remained low; my relationship suffered. I was moody. My girlfriend left me, unclear as to why but I suspect it had to do in part with intimacy, jealousy, and my moodiness. My energy had been and continued to decline along with my ambition; I lost gym gains due to dropping out of my routine and eating less healthily. I started having to take naps during my lunch break at work. I kept taking anastrozole through this, though, which I believe kept me from having terrible depression; instead I felt apathetic, kind of listless, and felt I was waiting for something to happen.
I found a new urologist for a second opinion because the new endo was not helping me get anywhere fruitful. I explained to this new urologist my entire history and current frustrations and symptoms. I told him I would prefer to find a way back onto Clomid as I had multiple concerns about T – fertility, mood swings, difficulty with getting the dosing right anymore. It had become clear to me amidst all this that my mood changed throughout each week with T cyp injections in a predictable way that I did not like. (I will note I have tried splitting the dose to every 3 days subcutaneously but still had a peak/trough fluctuation in mood and libido).
This brings me to today. I have been going back onto Clomid for 2 months now, gradually tapering T cyp and only staying at 25mg Clomid daily. I have yet to get labs but I can feel things are improving and leveling out. My mood feels largely the same day to day. My libido and sexual performance is quickly stabilizing; I know there is a psychological component at play as well, where I need to be able to trust my body will work consistently, so that will take time. My testicles are back to their full size which is reassuring. I will update as I get labs and things progress; I had my last T cyp injection of just 25mg a week ago.
So, that’s my story. I have read this forum extensively and found so much that’s helpful to me in improving my understanding of how I feel. I appreciate everyone who takes the time to post and answer and I want to do the same. Ask me anything.
Into my mid-20s I had still not needed to shave my face (having done so only in the hopes it would stimulate the growth that never came). At some point it hit me that I was behind my peers in my sexual conquests and interest. I’d had just one sexual partner to that time, a girlfriend of 5 years with whom I had split ways, and didn’t find myself really going after anyone else. Only in retrospect years later could I really understand how lackluster the sex was, because at the time it was both normal (I had no comparator except porn which I knew was not accurate) and because I didn’t feel disappointed by it.
The thing that ultimately pushed me to look into my testosterone, though, was my mood. I had been on antidepressants for years, but despite them always felt fatigued and emotionally volatile. I cried a lot. I would get to the college campus and be overwhelmed with sadness that was entirely illogical and sit and cry on a bench, or spend an entire weekend in bed burdened by a sense of worthlessness. Not helpful to my testosterone was that I started drinking heavily; it was the thing I gravitated toward for temporary relief, and as most of us know it does “work” in the short term at kicking the can down the road, but as most of us also should know by now alcohol worsens a hormonal imbalance.
At some point I became aware of the pain in my toe from all this can-kicking and decided there must be something “wrong” with me. Prior to that I had a depressive sense of guilt that my suffering was my own fault, my cross to bear, and that I was just destined to feel like shit for my life. It was a big change to allow myself to believe I might be able to feel better. I worked in the hospital setting at that point, night shifts, so had access to tons of resources that I dug into and all signs pointed to low T.
The thought of it made me embarrassed like it meant I wasn’t actually a man but a boy. It was embarrassing enough to keep me from asking my doctor about it unless I could really have some proof; low libido, depression, poor erections, no facial hair, and a skinny-fat type build (5’9, 165#) didn’t seem concrete enough to me. I ultimately found a place online that provides saliva testing for T. None of you should consider saliva testing for any kind of accurate numbers but as a screening method it was easy and cheap. I got those results back and my T was in the toilet, low enough that it seemed clear enough evidence to ask my doctor about.
Talked to my PCP and showed him the test I had done, he was quite nice and ordered a set of serum labs which told the same story – low T. I also had a bad cholesterol panel but normal thyroid. He unfortunately did not test estradiol, LH/FSH, SHBG, or others that would have been great as a baseline. He started me on a low dose of AndroGel and this gave me hope but it felt odd to be wiping on my dose of masculinity every morning. Unfortunately I lost insurance before noticing anything positive and had to start over a few months later with someone else.
I get a new primary through medical school. She was very patient and listened thoroughly to me and my concerns. She had me see the university’s urologist who was apparently a god in the world of men’s T treatment (John Barry, MD at OHSU). He took one look at me, listened to me talk about my issues, and told me I should start Clomid (clomiphene). It made sense to me – a medicine that made your body make its own T sounded so much better than injecting/wiping/pelleting/patching artificial manhood into/onto my body. I liked the idea of preserving fertility as well – keep in mind I was 26 at the time. With Dr Barry’s titration of the Clomid to 50mg daily I started to see results. I did not see those results until my T was up around 1100 (lab range was from 300-1080). Dr Barry reasoned that I have some mild androgen insensitivity which justified keeping it that high. I was having zero side effects, had balance with my estradiol, had resolution of my cholesterol, did not develop an elevated hematocrit, and felt amazing.
It was like my body was automatically converting my gut into muscle and sticking it onto my shoulders and pecs. I had the return of spontaneous erections that I had known only briefly in my adolescence. For the first time I had what felt like a truly masculine urge to fuck women, and I found myself feeling so much better with my mood and self-image that I actually pursued women and was successful. I no longer needed to take medicine to sleep. It seemed so easy. It seemed I had finally become the man I had been waiting for my whole life.
There were some interruptions along the way after Dr Barry asked my PCP to take over the medicine once I was stable. A covering PCP got a routine lab back and saw the T was high so told me to cut back the dose which I did, figured it was a good idea sometimes to make sure I was taking the minimum necessary, but felt my mood, energy, and libido all tank within a couple weeks or so. Returned to Dr Barry who resumed the 50mg dose and wrote me a letter to give to future doctors to keep them from messing with my treatment. I still have that letter in my fireproof safe.
A couple years later, after going from 1 to about 20 sexual partners through my pursuits, I had to move across the country. The PCP I picked up over on the east coast readily prescribed the Clomid 50mg a day which I continued in my year over there. I had 5 new partners in that year, finding myself in awe of the quality of woman I was able to meet and be with. The sex had become my primary objective and I was good at it. Note here that I am not trying to humblebrag – I will come back to this later.
In the last few months of that time, though (after being on the Clomid at full dose for about 2 ½ consistent years), I also started to get very emotionally volatile. Even with things going great – sex with apparently whomever I desired, making a solid 6 figures, new car, new experiences – I found myself sitting in my apartment considering how I could kill myself. I made plans to do it with my handgun. I didn’t try anything because ultimately I do have a logic in my head that is stronger than any of that shit could ever be over me, but that made the feelings no less disturbing or upsetting. At the time I wrote it off as homesickness and moved back to the west coast.
I arrive back west where I have a new job in a new community that is small. My new doctor there, despite my letter from Dr Barry and my voluminous medical records supporting my Clomid dose, said it was off-label and that I needed to see the only endocrinologist in town who was a woman. Feeling it would be easy to make my case with an expert I went ahead to that appointment, expecting to get the medication filled and be on my way.
However, this endocrinologist, who spoke English as a second language (relevant because I truly believe she had a hard time understanding accurately what I was saying about how I felt), did not like Clomid either. She said it was off-label and inappropriate. She also said my T was too high and that it was unsafe. I told her I did not respond well to lower doses and she told me I might need to see a psychologist for a gender identity problem. When she left the exam room to write me a woefully inadequate prescription for T cyp, I could literally hear her talking with the other women at the front desk and laughing about me. It was unbelievably maddening but also I got caught up on what she said about identity – not that I ever felt I was a woman, Jesus Fucking Christ that was upsetting – but I did wonder if I had some type of dysmorphia that meant I was not seeing the situation for what it was.
I became depressed even further, with my mood plunging in tandem with my T on the dose of T cyp 100mg every two weeks. I felt suicidal again. Let me emphasize something here, when I say suicidal I mean completely illogical and involuntary, unwanted intrusive thoughts about it being better to be dead than how I felt. I can assert to you it was in no way the kind of suicidal thinking that is needy, a cry for help, or indicative of some psychological weakness (I work in psychiatry now, I could recognize if that were the case and I have no reason to lie about it to you now). I don’t mean to disparage others who have had suicidal thoughts because I take those very seriously regardless of the context, but I want to emphasize for you reading here that I had these kind of thoughts emerge in a way that was very obviously directly related to my hormones.
I had nobody else to see in the area to talk to about my T situation. I kept with the endo’s prescription for T cyp which at best had my T up to mid-400s. I felt terrible. I called friends and family crying about all kinds of stuff. My work suffered. I tried to date but it was not going well. To get better care I drove over 2 hours to the nearest city and went to a “men’s clinic”. I knew the drill there, you go in and pay them cash and they give you T. I knew I needed something better than I had, though, and could not find a way to get the Clomid back, so hopped on the T bandwagon. The PA-C I met with had me start T cyp 200mg weekly with 1mg anastrozole, a common combo. Within a month I was roaring back, in fact feeling better than I had on the Clomid. All the benefits were there. My labs looked as they did when on Clomid, T around 1100.
In retrospect I believe my body’s response to the T changed over time. I found myself incredibly jealous of my girlfriend, an absolutely wonderful and trustworthy partner, getting to the point of paranoia about what she was doing when I was out of the house. I thought about putting cameras in my house to catch her with another dude. None of this was rational but it really hurt our relationship. Only looking back do I feel I can identify this was very likely during a time where my T levels were higher than they should have been.
A couple times I asked to try and return to Clomid, for sake of fertility, my shrunken testicles, and because I never liked the idea of injecting my masculinity. We tried two different strategies but neither worked; I can detail those separately. I returned to the T/anastrozole both times, but after the second try I definitely didn’t feel the same again.
Something had indeed happened to where my body was acting differently with the T; my levels were up above 1500 and my E was also high, and I felt my libido was suppressed until the end of every 7 day injection cycle. I pulled back on the T to see if I could find a balance. My sex drive remained low; my relationship suffered. I was moody. My girlfriend left me, unclear as to why but I suspect it had to do in part with intimacy, jealousy, and my moodiness. My energy had been and continued to decline along with my ambition; I lost gym gains due to dropping out of my routine and eating less healthily. I started having to take naps during my lunch break at work. I kept taking anastrozole through this, though, which I believe kept me from having terrible depression; instead I felt apathetic, kind of listless, and felt I was waiting for something to happen.
I found a new urologist for a second opinion because the new endo was not helping me get anywhere fruitful. I explained to this new urologist my entire history and current frustrations and symptoms. I told him I would prefer to find a way back onto Clomid as I had multiple concerns about T – fertility, mood swings, difficulty with getting the dosing right anymore. It had become clear to me amidst all this that my mood changed throughout each week with T cyp injections in a predictable way that I did not like. (I will note I have tried splitting the dose to every 3 days subcutaneously but still had a peak/trough fluctuation in mood and libido).
This brings me to today. I have been going back onto Clomid for 2 months now, gradually tapering T cyp and only staying at 25mg Clomid daily. I have yet to get labs but I can feel things are improving and leveling out. My mood feels largely the same day to day. My libido and sexual performance is quickly stabilizing; I know there is a psychological component at play as well, where I need to be able to trust my body will work consistently, so that will take time. My testicles are back to their full size which is reassuring. I will update as I get labs and things progress; I had my last T cyp injection of just 25mg a week ago.
So, that’s my story. I have read this forum extensively and found so much that’s helpful to me in improving my understanding of how I feel. I appreciate everyone who takes the time to post and answer and I want to do the same. Ask me anything.
The 
