Sex Issues on TRT

[TRTinNY]

Guys...

Could use some thoughts...my progress has been great. A lot more energy in general, been feeling good overall but have an issue.

I am 37 years old. I have a hard time reaching orgasm during sex as many times i feel desensitized. I have read through the forums spoken with my doctor and haven't gotten a great answer.

Most of the time i am able to get hard but many times i am not able to finish and can just keep going.

I just had my most recent blood work done on a trough right before my next shot was due. I do 25ML EOD Test Cyp and 250 IU E3D of HCG.

The results are as follows:

Luteinizing Hormone - <0.1 IU/L
Prolactin - 4.8 ng/mL - Reference Range - 4.1-18.4
Progesterone - 0.2 ng/mL
Testosterone Total - 492.2 ng/dL - Reference Range - 264.0-916.0
Testosterone Free - 22.8 pg/dL - Reference Range - 8.7 - 25.1
Estradiol (Ultrasensitive) - 26 pg/mL - Reference Range - < OR = 29
DiHydrotestosterone - 39 ng/dL

My doctor has had my try 5mg of Cialis every day. It seems to be a bit better but no where near what i should be.

Does anyone have any thoughts of what I can do to fix this issue?

 

[Systemlord]

Welcome to Excelmale,

No SHBG tested? SHBG is the bread and butter when it comes to sex hormones, it's responsible for activating and regulating free testosterone and estrogen. Realize injecting hormones isn't like taking Cialis where you get an almost instant action, when you start injecting hormones they must rebuild the body's tissues and regenerate the nerves in your penis that likely atrophied from the low T environment.

When one starts TRT it can take days or weeks before your HPTA shuts down because your pituitary sees you've got testosterone circulating in the blood, when this happens it often take months for your body to adapt. Often your protocol will need to be adjusted and once you find a dose and frequency of injections that right for you, only then will you feel like your old self again. You can't really accomplish this without knowing where your SHBG level is at. You may not even need Cialis in several months, there are some who have been able to completely recover enough to where they're able to stop using it.

However your protocol looks sound and suggests that you likely have low SHBG, otherwise you would be on large doses a little less frequently. Your TT numbers are on the low side, were these labs taken 4-6 weeks after you started TRT? Most guys feel fantastic in the 600-800 range.

 

[TRTinNY]

No SHBG tested? SHBG is the bread and butter when it comes to sex hormones, it's responsible for activating and regulating free testosterone and estrogen. Realize injecting hormones isn't like taking Cialis where you get an almost instant action, when you start injecting hormones they must rebuild the body's tissues and regenerate the nerves in your penis that likely atrophied from the low T environment.

When one starts TRT it can take days or weeks before your HPTA shuts down because your pituitary sees you've got testosterone circulating in the blood, when this happens it often take months for your body to adapt. Often your protocol will need to be adjusted and once you find a dose and frequency of injections that right for you, only then will you feel like your old self again. You can't really accomplish this without knowing where your SHBG level is at.

However your protocol looks sound and suggests that you likely have low SHBG, otherwise you would be on large doses a little less frequently. Your TT numbers are on the low side, were these labs taken 4-6 weeks after you started TRT?

My previous tests showed SHBG around 14-16. Those results are not complete yet from this round. Was also concerned about prolactin. I've been on TRT since April. I had to do my next injection right after this blood test was taken.

 

[Systemlord]

My previous tests showed SHBG around 14-16. Those results are not complete yet from this round. Was also concerned about prolactin. I've been on TRT since April. I had to do my next injection right after this blood test was taken.

It takes low SHBG guys longer to get all dialed in and feeling normal, my SHBG at the 4 week point was 18 nmol, it was low normal before I started TRT. I've been on TRT for almost 7 months now and it's a slow recovery compared to those that feel fireworks going off and are in the attacking the gym and getting ripped in a fast order. My muscles and joints have been sore since July without exercise, it's frustrating because all I want to do is go to the gym 4-5 days a week and get ripped. Erections are also slowly improving, wish I could somehow speed things up a bit. I'm on 50mg twice weekly and about to switch to EOD on Monday, I'm on no AI or HCG.

Erections and libido can take the longest to be restored, so many other thing have to be right for these to function.

 

[TRTinNY]

I've been dialed in pretty well...not sure if it is right

 

[DaveK22]

Have you ever taken any of the following drugs?
1. SSRI's (anti-depressents)
2. Propecia (finasteride)
3. Isotretinoin (aka Accutane)

 

[TRTinNY]

Have you ever taken any of the following drugs?
1. SSRI's (anti-depressents)
2. Propecia (finasteride)
3. Isotretinoin (aka Accutane)

A long while ago on SSRI...but nothing recent

 

[sportsfan8724]

Curious what does accutane have to do with this? I took it during teen years and always blamed it for having low t at a young age. Just curious why you brought it up?

 

[TRTinNY]

Any suggestions of what I can try and do?

 

[Leesto]

Yes SHBG will help your doc dial in your protocol. Did you have DHEA tested? Not that it is a cure-all but if low then it can have an effect on libido, sensitivity, climax, and other erectile issues. Some seem to benefit from it and some not. that's why a good knowledgeable doc and good labs are important. If verified low, it is cheap and easy to supplement. No prescription needed.

Best though to rely on labs rather than randomly changing things.

 

[Mrfrieze]

Welcome to Excelmale,

No SHBG tested? SHBG is the bread and butter when it comes to sex hormones, it's responsible for activating and regulating free testosterone and estrogen. Realize injecting hormones isn't like taking Cialis where you get an almost instant action, when you start injecting hormones they must rebuild the body's tissues and regenerate the nerves in your penis that likely atrophied from the low T environment.

When one starts TRT it can take days or weeks before your HPTA shuts down because your pituitary sees you've got testosterone circulating in the blood, when this happens it often take months for your body to adapt. Often your protocol will need to be adjusted and once you find a dose and frequency of injections that right for you, only then will you feel like your old self again. You can't really accomplish this without knowing where your SHBG level is at. You may not even need Cialis in several months, there are some who have been able to completely recover enough to where they're able to stop using it.

However your protocol looks sound and suggests that you likely have low SHBG, otherwise you would be on large doses a little less frequently. Your TT numbers are on the low side, were these labs taken 4-6 weeks after you started TRT? Most guys feel fantastic in the 600-800 range.

Regarding SHBG, when reviewing my lab work with me my Dr. only stated that my free T was extremely low. Seems like it was around 3 to 4. I know this info is vague. My question is does low free T basically mean low SHGB? I just got upped to 200 mg a week and seem to be having issues maintaining an erection. I have been supplementing with No2 which helps significantly but it seems like when I first started I was on 140 mg a week and I was having very strong erections.

 

[Systemlord]

Regarding SHBG, when reviewing my lab work with me my Dr. only stated that my free T was extremely low. Seems like it was around 3 to 4. I know this info is vague. My question is does low free T basically mean low SHGB? I just got upped to 200 mg a week and seem to be having issues maintaining an erection. I have been supplementing with No2 which helps significantly but it seems like when I first started I was on 140 mg a week and I was having very strong erections.

Actually high SHBG will greatly decrease free T, if your SHBG is high then large injections would be best, not worse. I believe your issue is E2 is starting to rise and that always hurts erections. Not many guys can take 200mg of T cyp without some elevated E2. If you just recently started then it's common since your HPTA shuts down a few weeks after your first injection do to your pituitary gland seeing plenty of T in your blood.

Are you on an AI?

How long you been on TRT?

 

[Vince]

"Testosterone Total - 492.2 ng/dL - Reference Range - 264.0-916.0
Just my two cents, don't you think your T is too low?

 

[TRTinNY]

"Testosterone Total - 492.2 ng/dL - Reference Range - 264.0-916.0
Just my two cents, don't you think your T is too low?

Vince...that was early in the morning on a trough...did my injection right after...you think that is too low right before I'm due meaning this could be causing a problem?

 

[Mrfrieze]

Actually high SHBG will greatly decrease free T, if your SHBG is high then large injections would be best, not worse. I believe your issue is E2 is starting to rise and that always hurts erections. Not many guys can take 200mg of T cyp without some elevated E2. If you just recently started then it's common since your HPTA shuts down a few weeks after your first injection do to your pituitary gland seeing plenty of T in your blood.

Are you on an AI?

How long you been on TRT?

Thanks for the reply, I realize actual lab results are preferred but I appreciate the insight. I am not on an AI. I started on 140mg on August 10, went to 180 6 weeks later after second labs revealed low readings. Then up to 200 after another 6 weeks based on symptoms. I am a fast metabolizer, so I have a drop off on like day 5. I am not having swelling of hands or feet, or nipple tenderness or itching. I can tell I am holding some extra water weight though. When I inquired about an AI they said my E2 readings were really low. However the test was done at trough, not peak estrogen.
I will definitely ask for an AI this week and see what happens. I feel a lot better for the first few days after injection but I really want to have a more positive experience in the bedroom.

 

[Vince]

Vince...that was early in the morning on a trough...did my injection right after...you think that is too low right before I'm due meaning this could be causing a problem?

Yes. I consider a trough level of 492.2 too low. I like my trough level to be around a thousand.

 

[CoastWatcher]

Vince...that was early in the morning on a trough...did my injection right after...you think that is too low right before I'm due meaning this could be causing a problem?

That could well be contributing to your situation. Most who report progress on TRT post a trough well north of the sub-500 value you posted.

 

[FeelingLost]

results are as follows:

Luteinizing Hormone - <0.1 IU/L
Prolactin - 4.8 ng/mL - Reference Range - 4.1-18.4
Progesterone - 0.2 ng/mL
Testosterone Total - 492.2 ng/dL - Reference Range - 264.0-916.0
Testosterone Free - 22.8 pg/dL - Reference Range - 8.7 - 25.1
Estradiol (Ultrasensitive) - 26 pg/mL - Reference Range - < OR = 29
DiHydrotestosterone - 39 ng/dL

My doctor has had my try 5mg of Cialis every day. It seems to be a bit better but no where near what i should be.

My experience with Cialis (5mg morning /5mg night) it helps with arousal and strength of my erection. It does nothing for my intensity of orgasm.

"Testosterone Total - 492.2 ng/dL - Reference Range - 264.0-916.0
Just my two cents, don't you think your T is too low?

Yes. I consider a trough level of 492.2 too low. I like my trough level to be around a thousand.

Hi Vince when I talk with Defy about my bloods they never really mention a TT goal.
It is always "we would like to see your Free T up around 35." On my last consult my FT was 18 and they doubled my T dose. I have only been with them for 2 months so I am still in the find the proper protocol mode.

So I was just wondering about your TT 1000 trough is that a number your Doc wants you to be at or are you just going by what feels best and the Doc is OK with it?
Also what's your Free T like at 1000+ TT? Does your Doctor ever talk about that?
thanks

 

[at15]

That could well be contributing to your situation. Most who report progress on TRT post a trough well north of the sub-500 value you posted.

a lot of those people are also on a light cycle not trt. We have data showing at 25, 50, and 125 mg per week there was no significant difference in sexual activity or sexual desire. Consider the 25 and 50 groups had trough levels in the 200's and 300's. Im not saying this is the case for everyone especially the older guys 60+ but trough around 500 and free test top end would not alarm me.

@TRTinNY, Proviron will fix your issue, but you may have to mail order if you cannot convince your doc.

 

[sportsfan8724]

Feelinglost defy said free t should be 35 at a trough? Or did you mean 25? 35 seems high for a free at trough. That would take over 200 mg a week for me. I'm at 200 mg a week split 3.5 days and I'm only ever high 20's at trough.