Somethings thats perplexed me in the 8 plus years of being on TRT is it's little to no effect on libido, in fact many men including myself had better libido in borderline or fully hypogonadal states. Testosterone undoubtedly has a huge effect on libido, but something with TRT for a large number of guys is missing. I have read, researched and studied to no end trying to find a solution to no avail. Since considerably lowering my dose I feel much better overall, but libido is still much to be desired. There are some theories that LH being suppressed is the culprit, which in essence should be partially if not fully corrected with peptides such as HCG. HCG does nothing for my libido, in fact it further deteriorates. My total T level was 440ng prior to starting TRT at age 36 and I still had a much stronger libido than ever at any point on TRT. I did have other symptoms at this level which have mostly been alleviated. I've went as far as trying Wellbutrin due to norepinephrine and dopamine having a substantial effect on libido, but still no difference. I understand the bodies physiological processes are delicate and supremely complicated which makes treating any hormone deficiency a complicated process. There's something that changes with suppressing the hypothalamic region of the brain by implementing TRT that isn't seen by labs and I'm absolutely convinced of this. I as well as many others have great labs on paper but still suffer from low libido and to some degree impotence while on TRT. Through all my reading over the last decade, libido by far is the hardest thing to attain on TRT. Hopefully one day through research and trials someone will figure it out. My father has had his hormones checked and he's now 72y/o and comes back a little over 400ng. He states he's as horny as he's ever been lol. There are even cases of men that aren't symptomatic with T levels in the 2-300ng range that still have strong libido. For the life of me, I cannot make sense of this.
Most common problem with TRT
- Thread starter sh1973
- Start date
I know its the not the case for everyone but getting E2/Estradiol at the right number gives me my libido back big time. Too high or too low and my brain can want it, erections can be had but its almost like things go numb -just no drive/enjoyment to use it. Its a much bigger factor for me than what my total or free T is at. I have been on HCG since day one though however.
Nashtide
Member
I hear what you're saying, but I'm not sure low libido is the most common problem for guys on TRT. Without thinking about it too much, I'd say estrogen regulation is the most common problem. Seems like almost every new guy struggles to some extent getting their E2 where it needs to be. Libido is a complicated issue and many factors other than testosterone come into play. I hope you get this figured out.
DragonBits
Well-Known Member
For me, my libido is strongly correlated with my testosterone levels.
With testosterone levels below 400 ng, I have a very weak libido. With TT above 900 ng/dl, libido was off the charts. My shbg was around 35-45, so my measured free T was around 27 pg/ml and over range when my TT was 900 ng/dl.
Note that when my TT was at 900, I was on nebido, I feel that nebido is less likely to spike estrogen, though I never measured estrogen when I was taking nebido so I have no idea what the level was. Less likely to spike estrogen since the TT levels only spike for a week every 3 months.
I am sure that other factors contribute to how we react to various hormones. Other factors such as vitamin D levels, magnesium, iodine, iron, boron, B vitamins, selenium, etc., and your general cardiovascular health.
There has been articles about the sensitivity and number of hormone receptors can differ from person to person, that would directly affect how we all react to the same level of hormones.
And not to be overlooked, your environment. Meaning if you are in a negative environment such as a troubled marriage, I think it can suppress your libido, while the opposite is true, having a hot woman around you can increase your libido.
It's not a help I know, but make sure your general health outside of TRT is the best you can accomplish, it might help with libido and even if it doesn't, it's good for your longer-term health.
I'm in the same boat with you. I just started TRT 6 weeks ago precisely because I had little to no libido. I'm 42 and the highest level TT I've had in years was 396. I tried HCG monotherapy and my total T dropped down to 383. The HCG did nothing for my libido. Since I've been on TRT for these 6 weeks my libido has slightly increased, but not at the times that I would like. My libido is highest in the morning and in the middle of the night like 1-3am which does nothing for me. Too early for sex either way.
I tried Maca root right after getting off the HCG monotherapy, but stopped because I was having ED problems. I didn't know if it was the Maca or the HCG, but I'm thinking it was the latter. Have you ever tried any of these so called natural supplements to help with your libido? I'm thinking of going back to the Maca root once again to see if it gives me the elusive libido that I seek.
Note: I started my TRT 6 weeks ago at 175mg and dropped down to 100mg these past 2 weeks after hearing better from the members on Excel. Maybe it's a little too early to gauge my TRT as ineffective, but I'm not pleased with the results thus far.
There's not much I haven't tried over the years as far as supplements, testing and lab work. I spent $600 on a nutritional deficiency test alone. I have no other health problems, never been overweight, don't smoke, rarely drink, eat healthy and work out regularly. Whenever I first started with Androgel 1.62 I maintained good libido for about a year or so on topicals and was forced to stop due to insurance coverage. I then went to Enanthate for a couple years then Cypionate for the last 4-5 years. I've had levels from 600ng to 1900ng and everywhere in between but have never had consistent libido. Like I said I now feel better in all aspects by dropping to 68mg per week, which puts my trough at 607ng day 7. I have SHBG levels in the 60-70 range, but high dosing DOES NOT WORK FOR ME whatsoever. anything above 1000ng is like hell for me. My libido got the worst around the five year mark and I've seen this same timeframe with other men be the time at which it seems these problems really start to appear. All in all I feel pretty well at this lower dose, but libido still is evasive even though I feel better. I've had some friends over the years that have did some hardcore anabolic cycles that have also stated after a while their libido pretty much vanishes, but after ceasing the cycle and doing a PCT their libido comes roaring back with a vengeance. It seems if a person is using HCG to possibly correct the absence of LH and FSH, that the hormonal cascade would essentially be fooled into thinking everything is in order. Obviously normal LH secretion normally happens in a pulsatile manner which I suppose could be a problem since HCG stays at a fairly stable rate. Perhaps lack of libido isn't the most common problem with TRT, but its well within the top few problems.
You're thinking the right way - 6 weeks is not long enough. And I have found that even very small changes in my protocol cause an unsettled period with the 2-3 week mark being the roughest. 2 weeks into dropping your dose 75mg, you're almost certainly experiencing this.
For perspective, it took me about 6 months to not only start to get close to figuring out a decent protocol (getting there but STILL fine tuning now at 9 months in) and to experience some of the benefits of TRT.
If I had to guess, I would say your free testosterone isn't high enough, or your E2 is out of range. When it comes to libido, I think about guys on steroids that talk about a raging libido most of the time. And if they lose their libido, they lower E2 and that usually does the trick. Yes, we're obv not doing steroid like dosages, but it just makes me wonder, why do most of them report an insane libido, and guys on TRT usually report a moderate-high libido when dialed in. I'm assuming it's due to the increase in free T with steroid users compared to guys on TRT. What else would cause it? Yes different compounds can effect libido differently, but I'm basing this off of anecdotal experiences I've read when guys are on a large dose of testosterone each week and no other orals or injectables. And ya we don't want their free T levels and risk our health, but I would assume if libido isn't where you want it, bumping up free T would get you closer to the libido you're looking for.
When it comes to E2, you're gonna get varying views. There's going to be some that say the E2 sweetspot is a myth, and to not focus so much on the numbers, and they're going to say that your body will regulate E2 on it's own. So if E2 is too high, you just need to lower your dose and your E2 will fall into place. But there are some guys that have low testosterone with normal E2 readings before TRT, like me. So obviously if you double testosterone levels, E2 is going to probably double and therefore be out of range. So I don't necessarily agree with that set of views. Then there are other guys who have reported that if their E2 is 10 points higher or lower than their sweetspot, it makes a huge difference in libido and well being. Idk who's right or wrong, but I'll tell you what. Those men that report seeing a huge difference when their E2 is in that "sweetspot", I guarantee aren't liars. It just doesn't make sense for any of us to lie or exaggerate our experiences. So when a doctor or forum member disregards someone's anecdotal experience because it doesn't match up with their thoughts on the subject, or what they have personally experienced, it makes me so mad. For some people, I 100% believe they have a sweetspot where they feel amazing. Do we all have one? I have no idea. Everyone is so different, it's hard to say. Only way to find out though is through trial and error, to see if dialing in E2 makes a difference. Maybe it will, maybe it won't. But it absolutely does for some people, that I know for sure.
Long story short, I personally would get your E2 within a normal range if it isn't already. And if that doesn't help libido, I would increase free T and see if that helps. If increasing free T makes E2 go up too much, I would try an AI and see if having a higher free T while keeping E2 within range helps.
When it comes to E2, you're gonna get varying views. There's going to be some that say the E2 sweetspot is a myth, and to not focus so much on the numbers, and they're going to say that your body will regulate E2 on it's own. So if E2 is too high, you just need to lower your dose and your E2 will fall into place. But there are some guys that have low testosterone with normal E2 readings before TRT, like me. So obviously if you double testosterone levels, E2 is going to probably double and therefore be out of range. So I don't necessarily agree with that set of views. Then there are other guys who have reported that if their E2 is 10 points higher or lower than their sweetspot, it makes a huge difference in libido and well being. Idk who's right or wrong, but I'll tell you what. Those men that report seeing a huge difference when their E2 is in that "sweetspot", I guarantee aren't liars. It just doesn't make sense for any of us to lie or exaggerate our experiences. So when a doctor or forum member disregards someone's anecdotal experience because it doesn't match up with their thoughts on the subject, or what they have personally experienced, it makes me so mad. For some people, I 100% believe they have a sweetspot where they feel amazing. Do we all have one? I have no idea. Everyone is so different, it's hard to say. Only way to find out though is through trial and error, to see if dialing in E2 makes a difference. Maybe it will, maybe it won't. But it absolutely does for some people, that I know for sure.
Long story short, I personally would get your E2 within a normal range if it isn't already. And if that doesn't help libido, I would increase free T and see if that helps. If increasing free T makes E2 go up too much, I would try an AI and see if having a higher free T while keeping E2 within range helps.
Reading through this thread about TRT and libido/sex, I figured this is a good place to share this story about my experience in that area with TRT. So here's a little personal anecdote that for me, is huge. TRT + low dose daily tadalafil has been nothing short of life changing for me in terms of sex. A few years ago, I injured my penis during sex. I was half in the mood, and therefore was half hard. Something didn't feel right. The next time I got an erection, it hurt. I figured "huh, that's kinda weird, but it'll probably go away". But it didn't. Erections continued to be painful and began to be very short-lived. It was like I would get an erection, it would be intensely painful, and it would quickly go away. Sex was becoming more difficult because of all of this, and I began to notice a slight curve in my penis when erect. For those of you who aren't familiar with this, this is how Peyronie's can present itself. I really couldn't believe this was happening to me.
Sex remained painful and became sort of a hurried activity - we'd have to hurry up and get it over with very quickly before my erection went away. Which was awkward and not very satisfying for either of us. Eventually it would get to the point where I just couldn't achieve penetration at all. I would get an erection, it would hurt (and have a slight upward curve to it that was never there before) and I would lose it within a minute or so. Venous leakage. I saw my GP and a urologist and both confirmed the presence of small plaques/scar tissues and Peyronie's.
I went home and read absolutely every article I could find on this condition. Sometimes it can resolve on it's own, which didn't happen for me. Surgery was not indicated in my case - apparently it is high-risk and only indicated with more extreme curvatures. Other treatment options also seemed hit and miss.
Basically, Peyronie's is one of those mysterious things that the medical community is still trying to figure out. But I noticed a trend in several of the scholarly articles mentioning a correlation between low T and Peyronie's. I decided to get my T levels checked. They were at the low end of the normal range for a guy in his late 30s, with one outlier below normal.
I began TRT. Starting TRT was a huge decision for me and I was afraid of possible unknown long-term consquences, but eventually I came to the rationale of "screw it, I'll take the long-term risks if there is a chance that I won't have to keep living like this for the next ___ years." And long story short, after months of trying different protocols, I found one that started working for me and began having nocturnal erections again. Note that I like to call them "nocturnal erections" rather than "morning wood" because not everyone has them present when waking up, but as long as it occurs at some point during REM sleep, that is what matters. This is when healing occurs in penile tissues. Prior to TRT, I can't remember the last time I had a nocturnal erection...probably in my teens. My erectile issues began to improve with TRT alone - still far from normal, but I did notice some improvement.
Things really took a turn for the better when I added in low dose daily tadalafil, which I learned about entirely as a result of hanging out on this forum. EM truly is an amazing resource. A dialed in TRT protocol + low dose daily tadalafil has effectively cured my Peyronie's at this point. I'm sure there are other ways that TRT can positively effect penile tissues, but I feel like the return of nocturnal erections aided by the improved blood flow with the tadalafil is what brought about the healing. I can now have pain-free, lasting erections again and any curvature has been reduced to the point that it is undetectable. I'm probably not 100% back to normal and may never be, but I can't begin to tell you how dramatic this improvement has been. This time last year I was wondering if my wife and I could ever have a normal sex life again - it was extremely stressful, despite how supportive my wife was at every step. Now we do. I'm convinced that TRT + low dose daily tadalafil made that possible.
EDITED TO ADD: Note that my E2 on what so far have been my most successful protocols has been high out of range in the upper 40s. I haven't had E2 in the normal range since beginning TRT.
Sex remained painful and became sort of a hurried activity - we'd have to hurry up and get it over with very quickly before my erection went away. Which was awkward and not very satisfying for either of us. Eventually it would get to the point where I just couldn't achieve penetration at all. I would get an erection, it would hurt (and have a slight upward curve to it that was never there before) and I would lose it within a minute or so. Venous leakage. I saw my GP and a urologist and both confirmed the presence of small plaques/scar tissues and Peyronie's.
I went home and read absolutely every article I could find on this condition. Sometimes it can resolve on it's own, which didn't happen for me. Surgery was not indicated in my case - apparently it is high-risk and only indicated with more extreme curvatures. Other treatment options also seemed hit and miss.
Basically, Peyronie's is one of those mysterious things that the medical community is still trying to figure out. But I noticed a trend in several of the scholarly articles mentioning a correlation between low T and Peyronie's. I decided to get my T levels checked. They were at the low end of the normal range for a guy in his late 30s, with one outlier below normal.
I began TRT. Starting TRT was a huge decision for me and I was afraid of possible unknown long-term consquences, but eventually I came to the rationale of "screw it, I'll take the long-term risks if there is a chance that I won't have to keep living like this for the next ___ years." And long story short, after months of trying different protocols, I found one that started working for me and began having nocturnal erections again. Note that I like to call them "nocturnal erections" rather than "morning wood" because not everyone has them present when waking up, but as long as it occurs at some point during REM sleep, that is what matters. This is when healing occurs in penile tissues. Prior to TRT, I can't remember the last time I had a nocturnal erection...probably in my teens. My erectile issues began to improve with TRT alone - still far from normal, but I did notice some improvement.
Things really took a turn for the better when I added in low dose daily tadalafil, which I learned about entirely as a result of hanging out on this forum. EM truly is an amazing resource. A dialed in TRT protocol + low dose daily tadalafil has effectively cured my Peyronie's at this point. I'm sure there are other ways that TRT can positively effect penile tissues, but I feel like the return of nocturnal erections aided by the improved blood flow with the tadalafil is what brought about the healing. I can now have pain-free, lasting erections again and any curvature has been reduced to the point that it is undetectable. I'm probably not 100% back to normal and may never be, but I can't begin to tell you how dramatic this improvement has been. This time last year I was wondering if my wife and I could ever have a normal sex life again - it was extremely stressful, despite how supportive my wife was at every step. Now we do. I'm convinced that TRT + low dose daily tadalafil made that possible.
EDITED TO ADD: Note that my E2 on what so far have been my most successful protocols has been high out of range in the upper 40s. I haven't had E2 in the normal range since beginning TRT.
Sean Mosher
Member
Having read the posts here for several years now I think the most common problem with men on TRT is doctors who don't understand it, how to treat it, how to read the lab numbers and how to get the patient optimal (symptoms resolved).
That's why the doctors who do (who are mostly cash pay and who are well known around here) are worth their weight in gold.
That's why the doctors who do (who are mostly cash pay and who are well known around here) are worth their weight in gold.
Interesting story, and glad to see you figured out a solution that worked for you! I can't even imagine how hard that would be to experience personally. Do you know what your SHBG level is? I'm just curious if it's on the higher end and that's why the higher E2 isn't an issue for you. Either way I wouldn't mess with your E2 one bit. I'm huge on if it isn't broke, don't fix it.
I'd have to agree with this 100%. I don't ever take finding Defy Medical for granted. They've been a true life saver.
Since I didn't start TRT with a particularly knowledgable TRT doc, I don't have a baseline SHBG number. 8 weeks into my first protocol (daily compounded cream) it was upper 20s. Now it seems to hover in the low to mid 20s. So definitely not high. I agree with you on the "ain't broke, don't fix it" approach to TRT. I'm currently on a T only protocol (no AI, no HCG) and it's been my best so far.
Gman I am currently with Defy and have consulted with Dr Crisler as well. I’ve had free t as high as 45 on a scale of 9-30 and E2 anywhere from 15-35pg/ml and honestly not much different anywhere. I’m not someone that’s been treated by incompetent doctors and I have been at this over 8.5 years. I’m in no way saying some guys don’t do well or saying anyone is a liar. I’ve been cruising these boards for a decade and I can tell you for certain libido issues are a problem with TRT. It seems to affect long term guys such as myself to a higher degree. Trt is not just estradiol and testosterone. Testosterone itself affects just about every tissue, hormone and neurotransmitter in the body. I’ve seen guys over the years take tiny doses of cabegoline to bump their dopamine up and cure their libido issues. We’re all different and all have different experiences with hormone replacement. I feel much better with my total t in the 600-700ng range with free t in the 10-15 range, but that’s just me. My libido issues are the same whether free t is 10 or 30 or E2 is 10 or 30.
I too had difficulty in my first 6 years of TRT. Getting erections wasn't consistent and if I did I didn't feel much of anything. Orgasms were rarely possible. Then about 6 years in my MD [FONT=Open Sans, sans-serif]started back filling my pathways, put me on HCG and started optimising DHEA and Progesterone and pregnanlone etc. This took some time but it was a game changer for me. Suddenly I had erections when I wanted them and I had great sensitivity for the first time in years. I could now orgasm normally and it continued improving over time. Now erections, sex and orgasms are as good as it's ever been for me and it was all about optimising other hormones. This has been my experience and a lot of this was me reading and prompting my MD to try to get all my hormones optimised. During the course of optimising other hormones all my anxiety/stress problems faded away. In my case it was clear the benefit of doing all this. [/FONT]
Ratbag that’s great to hear. If you don’t mind my asking, what is your current meds and protocol?
I'm hypopituitary due to a head injury when 7 yrs old. So here's the big list.. I recently managed to get off Florinef.
Cortisol 30mg daily (15+10+5)
Synthroid 250mcg daily
Cytomel 20mcg daily
Test-C 45mg E3.5D
HCG 500iu E3.5D
Losartan 50mg daily
Progesterone cream approx. 11mg daily
DHEA 50mg daily
Pregnenolone 25mg daily
LDN (Low Dose Naltrexone) 4.5mg daily
Iron 25mg tablet daily
Metformin 1000mg daily
Iodine 12.5mg daily
Vit B-12 1000mcg daily
Arimidex .125mg E3.5D
Magnesium 600mg daily
Cortisol 30mg daily (15+10+5)
Synthroid 250mcg daily
Cytomel 20mcg daily
Test-C 45mg E3.5D
HCG 500iu E3.5D
Losartan 50mg daily
Progesterone cream approx. 11mg daily
DHEA 50mg daily
Pregnenolone 25mg daily
LDN (Low Dose Naltrexone) 4.5mg daily
Iron 25mg tablet daily
Metformin 1000mg daily
Iodine 12.5mg daily
Vit B-12 1000mcg daily
Arimidex .125mg E3.5D
Magnesium 600mg daily
Nashtide
Member
I also think libido can run the gamut from full on 15 year old continuous state of horniness to absolutely zero interest in sex. So some guys will report a healthy libido if they desire sex a couple of times per week with their wife while others consider a healthy libido if they want to screw every woman they see. Both very different levels but both guys reporting good libido. A lot of these issues are perspectives based on individuals. Libido can't be measured in a blood test.
Share this page
Sponsors
Online statistics
- Members online
- 6
- Guests online
- 7
- Total visitors
- 13
