Sporadic bouts of good libido/sensitivity on TRT, now just flatlined.

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Brief history... past 3 years or so I'd have periods of low mood and reduced drive, libido and most recently reduced erection sensitivity. I'd get them just fine or sometimes would need cialis but there just wouldn't be any pleasure there. So after getting fed up I got into the doctor, got my blood tested. I had lower range total T, 420 and barely in the normal range Free T.. just a point or two from low. Insurance finally approved androgel with the low free T number and I tried that. Was probably all placebo effect but the first 7 days were good then I started having night sweats and more anxiety, then the wood stopped all together and my mood went to shit. So I stopped the gel and decided to try to improve my T naturally. Cleaned up an already decent diet, added a bunch of supplements that should help and started intermittent fasting. I actually had some success with that and thought I was getting the issue resolved. Then I hit small flatline, it would improve for a few days again and then it just went downhill from there. A about a week after that I finally went to a TRT clinic and got tested again. Total was now 570, the didn't tell me the Free but my estradiol sensitive was 58. They started me on 150mg Test Cyp once a week, 1mg anastrozole on injection day and HCG 500IU twice a week.

After the first anastrozole and some reading I decided to break that up in to .25mg about every other day. I stayed with this for 4-5 weeks before I had a sudden spike of libido and my sensitivity was back big time. It was absolutely wonderful, litterally like being 18 again. Then I'd have a few lower days, another great week and then followed that up with having good days about every other day.

Now over the past week it has been absolutely dead... no libido, sensitivity is poor. I can still get it up, but I don't feel much. Just last night I went to bed, had a nice erection but no pleasure.

With my 6 week blood work my trough day was 900 and my E2 was 48 (I'm now on week 8). Did not have any HCG the week before my shot.

Once I started to have up and down days I tried adjusting the anastrozole dose, thinking maybe my E2 was climbing based on symptoms. The first couple times I would take an extra .25mg I would feel more calm within 6-24 hours and libido and sensitivity came back. However, the last couple times I tried this I would feel worse and it would not improve libido/sensitivity. The effect could have been all placebo I suppose.

Now I'm completely frustrated, worried and really pissed off. I stopped taking anastrozole for the time being as I want to see how I do on TRT without any. Even though I started out high, if my peak days are around 1100 then that wouldn't be a terrible T to E2 ratio. Unless however I'm one of those guys who needs to ignore the ratio a bit and worry more about the E2 number and get it below 30.

I've had a lot of the other benefits of TRT... better mood, increased focus, more drive, better athletic performance and recovery.. all that stuff is great but this libido thing really bothers me. I need that in my life to feel like a man. Everything else just falls short of providing that sense of well being.

This week while stopping the anastrozole I did decide to go to 2x a week on the injection, so about 75mg twice a week instead of 150 once a week. 2nd shot this week will be tomorrow and I'm about 3 days now without anastrozole. No improvement yet.

Anyone out there have any recommendations? I'm so lost/disappointed at this point. Those good days were awesome but were also quite the "tease" at this point.

I should note that other than lack of libido/sensitivity I haven't really had any of the other symptoms of high estradiol. No nipple stuff etc. I had some bouts of being emotional prior to TRT, but not really since then.
 
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yes, getting the sensitive test for men. don't have the actual results on those, clinic hasn't sent them over yet, just going by what they told me when I had a visit. Also my H&H was good at 6 weeks as was the PSA... like a 0.3.

I need to get my post count up to add the links.. just a sec.
 
Only real issue with my bloodwork there was some high triglycerides. I messed up and had some candy late the night before (and the whole weekend prior was not good diet wise) the test the next morning, may have skewed it some but part of my adjustment since then is a big cut in simple sugars and I cut my carb intake down quite a bit. Wouldn't be surprised to see that in range on the next test.
 
IN a paraphrased sense all I'm seeing is you starting this, stopping that, then starting something else, changing this, and I feel this today so I changed this today...you can't operate this way. Steady, consistency, backed with labs...no one can be successful approaching this the way that you are. Admittedly your story isn't unfamiliar with a lot of guys, there's still good days and more flat days, but absolute consistency for consecuctive weeks could help narrow things down. You get the labs, staying on course, and then approach a small change and stay constant with that.
 
Yeah, you're right. In my defense though I don't feel the changes have been drastic.
I was steady for the first 6 weeks. Once a week injections, 1mg anastrozole a week and 2x HCG 500IU a week
Adjusted anastrozole up by about .25 a week the past two weeks (weeks 7 and 8)
Just switched to 2x a week injections this week (week 8)

The ups/downs made me jump the gun perhaps. Would I be better off going back to beginning protocol now or stay this course? (more change ; )


IN a paraphrased sense all I'm seeing is you starting this, stopping that, then starting something else, changing this, and I feel this today so I changed this today...you can't operate this way. Steady, consistency, backed with labs...no one can be successful approaching this the way that you are. Admittedly your story isn't unfamiliar with a lot of guys, there's still good days and more flat days, but absolute consistency for consecuctive weeks could help narrow things down. You get the labs, staying on course, and then approach a small change and stay constant with that.
 
Did I miss the estradiol results? I looked and didn't see them. The ratio, T & E, is a guide, not an absolute.

Your total testosterone results were middling, to put the best spin on it I can. When did you have blood drawn? What is your SHBG? What about DHT? These results reflect what protocol? You've so many ,icing parts trying to isolate anything is a challenge.
 
Yeah, you're right. In my defense though I don't feel the changes have been drastic.
I was steady for the first 6 weeks. Once a week injections, 1mg anastrozole a week and 2x HCG 500IU a week
Adjusted anastrozole up by about .25 a week the past two weeks (weeks 7 and 8)
Just switched to 2x a week injections this week (week 8)

The ups/downs made me jump the gun perhaps. Would I be better off going back to beginning protocol now or stay this course? (more change ; )

It sounds like your TRT honeymoon phase is over, it happens to all of us once your HPTA is shut down. If you maintain a steady protocol and don't make change every couple of weeks you'll be rewarded with everything you've been hearing about TRT.

I don't think you realise it takes most guys MONTHS to start feeling normal again once their protocols are all dialed in, I've been on TRT for almost 5 months and symptoms are improving SLOWLY. These are hormones we're talking about here, there's no quick fix for hormones.

I see a lot of guys give up early in the game because they're expecting immediate results.
 
If you maintain a steady protocol and don't make change every couple of weeks you'll be rewarded with everything you've been hearing about TRT. I don't think you realise it takes most guys MONTHS to start feeling normal again once their protocols are all dialed in, I've been on TRT for almost 5 months and symptoms are improving SLOWLY. These are hormones we're talking about here, there's no quick fix for hormones.
An excellent perspective. For every man who starts TRT and sails on with no issues, steadily improving, not a single adjustment (and there are some who do fall into this category), the vast majority require course corrections...that take weeks to sort themselves out, if not months. You have reason to be hopeful...if you can find the patience.
 
Estradiol was 58 the day I started TRT, it was 48 after 6 weeks on TRT. I don't have SHBG or DHT, unless they appear on the test results the clinic is supposed to send me. They only told me my T and and E2 levels, I didn't get the printed results yet. Will drop them here once I do. The blood tests posted were in late April from my docs office. I have two other blood draws from 8/17 and from 6 weeks prior to that from the clinic.
 
Estradiol was 58 the day I started TRT, it was 48 after 6 weeks on TRT. I don't have SHBG or DHT, unless they appear on the test results the clinic is supposed to send me. They only told me my T and and E2 levels, I didn't get the printed results yet. Will drop them here once I do. The blood tests posted were in late April from my docs office. I have two other blood draws from 8/17 and from 6 weeks prior to that from the clinic.

Please post your most recent results. We can't offer any points if we're not addressing lab results that are current.
 
I am wondering if you need to increase your injection frequency. This really helped me and as others have said, be patient. I have basically the same issues as you. Though my ED as more severe. It's taken nearly a year for my ED to be greatly improved. I can now get and maintain an erection without Cialis again. My sensitivity is still not where it was before all of this mess started 2 years ago. But it's manageable now, don't get me wrong it has improved for sure, I am just not 100% there with regards to sensitivity.
 
Your T is borderline. I would increase the dose 50%. I would stop anastrozole and bring in 500 IU HCG twice per week. I would start 5 mg per day Cialis also. Next time check your Total and Free T, Estradiol (Sensitive) and DHT.

One more thing, if you are masturbating a lot watching porn...stop it.

Here is a panel that looks into variables that affect erections and libido.
https://www.discountedlabs.com/ed-panel
 
The labs below are pre TRT numbers, so yeah they were borderline. Since then I started 150mg of Test Cyp once a week, 500IU HCG twice a week and 1mg anastrozole once a week. I just don't have the actual records for my 6 week follow-up on TRT yet. But my trough day was 900 and E2 sensitive was 48 that day. Once I have that lab info or new labs I will post those. I'm going on 10 days now that my libido/sensitivity has been just dead in the water after a couple weeks that were pretty great (no cialis required). Over these 10 days I've only had one dose of anastrozole .25mg thinking perhaps I dropped too low but other than the libido/sensitivity thing I haven't had any side effects of low or high estrogen except getting pretty damn depressed or pissed that my junk won't work right.

Your T is borderline. I would increase the dose 50%. I would stop anastrozole and bring in 500 IU HCG twice per week. I would start 5 mg per day Cialis also. Next time check your Total and Free T, Estradiol (Sensitive) and DHT.

One more thing, if you are masturbating a lot watching porn...stop it.

Here is a panel that looks into variables that affect erections and libido.
https://www.discountedlabs.com/ed-panel
 
So, stop the anastrozole completely. It's not going to kill you and you may wake up to the fact that you don't need it as your libido and sensitivity improve (or not).
 
Just an update... I cut out the anastrozole for about 10 days. Started gaining some weight with no diet changes so I felt that was a sign to restart it. So I've been doing .25mg every couple days along with Dim and Calcium D-glucarate. Feeling really good the past 3-4 days and libido is back, really close to where it was. If it was an 8 out of 10, its about a 7 or so now. During this time I also started DHEA cream once a day. I have a full blood work scheduled soon so I'll see where I'm at. I can't say for sure that my E2 crashed but its possible. Will see if I really need the DHEA and what the AI is actually doing to my E2. I listened to some podcasts with Dr. Crisler and his comments led me to try the DHEA. I've used DIM before but never with the the calcium D-glucarate, usually with TMG instead.
 
Beyond Testosterone Book by Nelson Vergel
Just an update... I cut out the anastrozole for about 10 days. Started gaining some weight with no diet changes so I felt that was a sign to restart it. So I've been doing .25mg every couple days along with Dim and Calcium D-glucarate. Feeling really good the past 3-4 days and libido is back, really close to where it was. If it was an 8 out of 10, its about a 7 or so now. During this time I also started DHEA cream once a day. I have a full blood work scheduled soon so I'll see where I'm at. I can't say for sure that my E2 crashed but its possible. Will see if I really need the DHEA and what the AI is actually doing to my E2. I listened to some podcasts with Dr. Crisler and his comments led me to try the DHEA. I've used DIM before but never with the the calcium D-glucarate, usually with TMG instead.

I would definitely either completely cut out the AI like Nelson said, or cut back to .25mg E3.5D. Maybe even less if you can at .125mg E3.5D. Don't make any more changes. I'd bet that you've got pretty low E2 when you were doing 1mg anast a week.
 
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