Need honest advice: Do I really need TRT? Low-normal T, low libido for years, anxiety/OCD background, little muscle growth

AceofSpades · 2025-11-02T12:07:05-0600

Hey guys,

I’m 31 years old and I’ve been struggling with a very low libido since I was about 19. Before that, I was extremely driven, confident, and constantly attracted to women. Over the years, my sex drive almost completely disappeared. I rarely feel “horny,” don’t feel the urge to flirt or chase women, and I’ve lost that natural masculine energy and confidence.

I also deal with anxiety/OCD-like symptoms - mostly intrusive thoughts/feelings, health anxiety, and a general sense of inner tension and emotional flatness (anhedonia). I’ve been in therapy, tried medication, hypnosis, etc., but nothing has fixed the core issue of low libido and emotional blunting.

Here are my blood results (two separate tests, morning blood draws):

Total testosterone: 12.35 nmol/L (≈356 ng/dL)
Free testosterone: ~240 pmol/L
Free Androgen Index: 38 (reference 35–92.6)
Estradiol (E2): normal
LH, FSH, Prolactin: all within range
SHBG: normal range
Thyroid, liver, lipids, vitamin D: all normal

I’ve also been training consistently for about 3 years (strength and hypertrophy focus), but I’ve noticed very little muscle growth and slow recovery, despite good nutrition and consistency. That’s another reason why I’m wondering if my testosterone level might be holding me back.
I eat clean, get decent sleep, train 4–5x a week, and don’t use drugs or smoke. I drink occasionally but not excessively.

But I’m still unsure if TRT is really the right move or if my problems are mainly psychological.

I have some good days where libido improves a bit, but most of the time it’s completely gone. I also notice that when I drink alcohol or when I’m in a relationship, I sometimes feel more “normal” again - more relaxed and a bit more sexual.
Physically I can get an erection and orgasm, but it feels mechanical - the desire and “fire” behind it are gone. It’s like my brain isn’t interested even though my body can perform.

So my main questions to you guys are:

With my numbers, would you personally start TRT?
Is it possible that my issues are mostly psychological and not hormonal?
Have any of you experienced similar “low-normal” T levels with strong symptoms and found TRT life-changing?
Could TRT help with anxiety and emotional numbness in addition to libido?

I’m scared that my problem might actually be psychological, not hormonal - since my OCD also includes sexual/intrusive themes, and I know low libido can sometimes come from anxiety or obsessive thinking.
On the other hand, even when my OCD isn’t active, my libido doesn’t really come back either - so I’m stuck not knowing which it is.
I also worry about the long-term commitment of TRT - being dependent on it for life, the potential impact on fertility (I want to have kids), and possible long-term side effects.

And honestly, I feel like the best years of my life have already passed me by. It’s like I’m just existing, not really living.
No real motivation, no excitement about meeting women, no drive for goals or going out with friends - just this constant sense of flatness.
I just want to feel alive again, confident and passionate, like the person I used to be.

Any advice or perspective would mean a lot.

Thanks, guys.

Seagal · 2025-11-03T11:49:58-0600

I asked my AI, it suggested you try TRT.

Imo, it sounds multifactorial. It's difficult to give any advice.
Do you have a problematic porn consumption?

AceofSpades · 2025-11-03T12:01:29-0600

Seagal said:
I asked my AI, it suggested you try TRT.

Imo, it sounds multifactorial. It's difficult to give any advice.
Do you have a problematic porn consumption?

Thanks a lot for your reply, I really appreciate it.
I don’t think porn is a major issue for me - I actually watch very little these days, sometimes none at all.

To be honest though, porn is pretty much the only reliable way for me to reach orgasm at the moment. It can work with thoughts alone, but it’s very difficult and takes a lot of focus or effort.

Seagal · 2025-11-03T12:55:36-0600

AceofSpades said:
Thanks a lot for your reply, I really appreciate it.
I don’t think porn is a major issue for me - I actually watch very little these days, sometimes none at all.

To be honest though, porn is pretty much the only reliable way for me to reach orgasm at the moment. It can work with thoughts alone, but it’s very difficult and takes a lot of focus or effort.

Regarding your concerns about fertility, you could search the forum for oral testosterone. I have no experience with it but that's what I would use (if I had access to it) to start or try TRT.