Starting Over

4everyoung · Saturday at 2:02 PM

Hello all,

Like the title suggests, I’m looking to start over on the TRT journey.
I’d like to state up front that I prioritize sleep hygiene(though I do have some sleep issues), I eat right and exercise regularly.
Despite these things, over the past few years my libido has steadily dropped to zero and nothing I’ve attempted has moved the needle.
I started TRT in 2018 and had a long honeymoon period (though it had some ups and downs) where my libido was excellent. At its peak I was having sex 10 to 15 times per week.
Somewhere around 2023 it really started to taper off and despite adjustments to my protocol it essentially reached zero about a year ago, with no desire for my partner, porn or anyone else for that matter.

I had been with Defy since the beginning, but nothing they suggested helped. I eventually had my primary start prescribing test cyp.

My last protocol was 10mg Test Cyp per day, 150iu HCG per day and .08mg Anastrozol per day.
I tried moving the HCG to E3D as I read it would be more effective that way but didn’t notice any change.
I tried dropping the HCG but only noticed my testicles shrinking to the size of raisins, but no other noticeable changes.
I tried dropping the AI but noticed no changes.
Defy also had me try testosterone cream and various supplements to no avail.

My test levels were hovering somewhere around the 700 range, with my E2 in the 20’s to 40’s with and without AI respectively.
Also, worth noting, I have low SHBG. It was in the 14 range if I’m not mistaken.

Back in February I decided to try to do a reset and stopped all the above and started taking clomiphene. I only took it for about a week and then stopped it as well.

Overall, other than losing a bit of muscle mass and gaining a few pounds and my testes returning to a more normal (though not nearly as large) size, I feel no different...ZERO libido.

I’d like to start fresh in the hopes that perhaps the low libido issues now are related to low test and not whatever they were before and that I might be able to get my libido back if even for just a time before doing another reset.

I’m hoping that you all could help me with figuring out what all tests I can get ordered to get an accurate baseline off test and then any advice on the best way to go about restarting.

I was thinking that perhaps I could first try HCG mono therapy and go from there.

Any help anyone could offer is desperately needed and greatly appreciated.

Cataceous · 2026-07-19T10:02:47-0500

I can share some ideas, but their relevance somewhat depends on your current numbers—at least an accurate morning free testosterone, or total testosterone plus SHBG. These would answer the significant question you brought up: Is low testosterone the culprit now, versus possible other hormonal imbalances while you were on TRT? I continue to promote the proposition that TRT can suppress/disrupt multiple hormones, which in some cases leads to poor libido. Through experimentation I have found that improving the hormonal milieu even while on TRT can improve libido. For example, using enclomiphene and gonadorelin led to sustained improvements. This specific approach is not sustainable for most, but could be used as a diagnostic tool. Simpler, however, is to trial a fast-acting form of testosterone for at least a couple of months. Fast-acting testosterone includes nasal gels and buccal troches. The idea is that if your other hormones—i.e. kisspeptin, GnRH, LH—are at acceptable levels, and only testosterone is low enough to cause symptoms, then fast acting testosterone remedies the hypogonadism without too much suppression of the other hormones. In practice things like Natesto are not a panacea, but I think you could get some useful information from a trial without too much effort.

Because you're a client of Defy Medical you should be able to obtain Empower's nasal gel pretty easily. I would emphasize that the dosing must be modest to avoid suppression. With Nasesto one is using 22-33 mg of testosterone daily, of which about 10% is absorbed. Make sure dosing of generic nasal gel is in line with this.

In addition to free testosterone by equilbrium dialysis ( or calculated via TT and SHBG), I would also measure a baseline LH and estradiol before restarting TRT. You could throw in prolactin and the free thyroid hormones while you're at it.

It is rare to see hCG monotherapy be successful long-term. I think your time and money would be better spent on other approaches first. If normalizing the sex hormones doesn't do anything for libido then you might wan't to think about neurotransmitters, e.g. dopamine, etc. Various medications and supplements can be used to tinker and gather information. Even a short trial with microdoses of PT-141 could yield some interesting results.

C

Thread 'PT-141 Dosing Guide: The Low-Dose Strategy That Works Better'

Sep 28, 2023

Could microdosing PT-141 (bremelanotide) deliver better libido results than standard doses? Many men find that typical PT-141 doses (500mcg-2mg) produce disappointing or inconsistent effects on libido—but a different dosing strategy involving multiple small daily doses may unlock dramatically better results by better mimicking natural α-MSH physiology.

This detailed discussion documents a protocol using 15-20mcg of bremelanotide injected 5 times throughout the day, which produced high sustained libido and easy erections—far superior to single large doses. We discuss the science...

4everyoung · 2026-07-20T17:48:24-0500

These are excellent thoughts, thank you for taking the time to reply.

I will put these tests on the list.

I'm not currently a patient at Defy, but will likely re-join the club in order to get easier access to these particular meds.

Also, PT-141 was one of the peptides they Had me try. The first time I tried it it made me a bit nauseous, but produced a very random erection just without any sex drive to go along with it. It was very peculiar. I tried it several other times without much success iirc.

Thank you again. I'm going to continue researching and will post the lists of test I intend to take to hopefully get a finally opinion before the blood draw.