Stopped low dose AI, now experiencing ED?

[donkeyfarlo]

I've been on 40mg test cyp EOD for a number of months, and up until August 3rd (roughly 3 weeks ago) was taking 0.125mg compounded anastrozole every 6 days. This protocol seemed to work well and I felt pretty well balanced.

I've recently moved into a new state which happens to be one of the only states compounding pharmacies will not ship to unless your prescribing physician is based locally in the state. I decided to just forego the AI as I'd rather not be taking it anyway, and was hopeful that such a small dose might have just been placebo.

As I said, it's been 3 weeks since dropping the AI and for the first time in 2 years I'm experiencing ED, despite also taking 5mg tadalafil daily. I've also had a day or two of being overly obsessed with sex along with flushing and an increase in body temperature, symptoms I have previously associated with higher than optimal estrogen.

I'm wondering if this is just part of the ~5-6 week adjustment period which occurs after any protocol change and I should just wait it out, or if I should try changing the timing of my doses, perhaps every three days instead of EOD.

I'm open to any suggestions you all might have.

 

[Systemlord]

I've been on 40mg test cyp EOD

The problem with maintaining hormone levels for men who are sensitive to hormones, with smaller fluctuations estrogen is always elevated, no so on oral testosterone, Jatenzo, Kyzatrex, Orlando, due to the PK profiles.

You could always lower your Test dose and inject smaller doses daily. Oral testosterone tends to have less side effects. The advantage to oral testosterone, if you need to stop for any reason, I returned to a normal HPTA functionality in 8 days due to the very short half-life.

On the flipside, you reach steady states in 7 days, no more roller-coaster for 4-6 weeks.

 

[FunkOdyssey]

I'm wondering if this is just part of the ~5-6 week adjustment period which occurs after any protocol change and I should just wait it out, or if I should try changing the timing of my doses, perhaps every three days instead of EOD.

I'm open to any suggestions you all might have.

I would just wait and see what happens. I think there's a good chance you adapt to the change and recover your erections given more time.

 

[donkeyfarlo]

The problem with maintaining hormone levels for men who are sensitive to hormones, with smaller fluctuations estrogen is always elevated, no so on oral testosterone, Jatenzo, Kyzatrex, Orlando, due to the PK profiles.

You could always lower your Test dose and inject smaller doses daily. Oral testosterone tends to have less side effects. The advantage to oral testosterone, if you need to stop for any reason, I returned to a normal HPTA functionality in 8 days due to the very short half-life.

There certainly seems to be a push lately on the forum for Kyzatrex.

Is it simply that much better than injections and everyone is trying to spread the good word?

 

[Seagal]

I've been on 40mg test cyp EOD for a number of months, and up until August 3rd (roughly 3 weeks ago) was taking 0.125mg compounded anastrozole every 6 days. This protocol seemed to work well and I felt pretty well balanced.

I've recently moved into a new state which happens to be one of the only states compounding pharmacies will not ship to unless your prescribing physician is based locally in the state. I decided to just forego the AI as I'd rather not be taking it anyway, and was hopeful that such a small dose might have just been placebo.

As I said, it's been 3 weeks since dropping the AI and for the first time in 2 years I'm experiencing ED, despite also taking 5mg tadalafil daily. I've also had a day or two of being overly obsessed with sex along with flushing and an increase in body temperature, symptoms I have previously associated with higher than optimal estrogen.

I'm wondering if this is just part of the ~5-6 week adjustment period which occurs after any protocol change and I should just wait it out, or if I should try changing the timing of my doses, perhaps every three days instead of EOD.

I'm open to any suggestions you all might have.

Why did you take anastrozole?

 

[donkeyfarlo]

Why did you take anastrozole?

There is a very long answer to this, which began when I crashed my estrogen with it on advice from an unqualified HRT doc, so don't worry, I am not remotely interested in taking it if I can avoid it.

I spent 12+ months working with a qualified doc trying to get everything back in balance, and at the time it seemed like the tiny dose every 6 days managed that. I do think it is likely no longer necessary, these symptoms just caught me by surprise.

 

[Gman86]

Before I even finished reading ur initial post, I was gonna ask u if u experienced a higher libido, even tho erections seem to be suffering. I’ve seen higher estrogen associated with higher libido, but softer erections, enough times to associate that scenario with E2 that’s too high for that individual. U then proceeded to report that he libido seems to have increased, which only reinforced what I’ve seen anecdotally throughout the years. So I think it might be safe to say that u are in fact experiencing high E2 symptoms, atm, which obv makes sense, and might be a durrr statement.

But sticking things out, like Funk said, isn’t a bad idea. There’s definitely a chance that ur body could adjust to the higher levels of E2, and ur erections could improve. But then there’s obv a chance that things continue to stay the way they are, no matter how long u give it. So maybe stick it out a bit longer, and see if things improve or not. If they don’t, it seems like he pretty limited, but this whole not being able to receive anything from compounding pharmacies. How are u getting ur test? Ur doc sends the script to a local pharmacy? If u do end up needing some estrogen control, u could always do the same thing with an ai. I used to have my doc send the script to my local pharmacy, and then use my insurance to get it pretty cheap.

Other than that, I guess all u can do is lower ur dose, and/ or change the frequency of ur injections. But wouldn’t decreasing the frequency of ur injections possibly increase estrogen?

Actually, maybe try out something like calcium d glucarate, to control high estrogen symptoms. Seems like some guys see positive results with it

 

[donkeyfarlo]

Before I even finished reading ur initial post, I was gonna ask u if u experienced a higher libido, even tho erections seem to be suffering. I’ve seen higher estrogen associated with higher libido, but softer erections, enough times to associate that scenario with E2 that’s too high for that individual. U then proceeded to report that he libido seems to have increased, which only reinforced what I’ve seen anecdotally throughout the years. So I think it might be safe to say that u are in fact experiencing high E2 symptoms, atm, which obv makes sense, and might be a durrr statement.

Yeah, I got that "obsessed libido" thing with the hot flashes for the first time since long ago when I was first getting my routine dialed in, so pretty sure it's high E2; not crazy high, just too high for me.

But sticking things out, like Funk said, isn’t a bad idea. There’s definitely a chance that ur body could adjust to the higher levels of E2, and ur erections could improve. But then there’s obv a chance that things continue to stay the way they are, no matter how long u give it. So maybe stick it out a bit longer, and see if things improve or not. If they don’t, it seems like he pretty limited, but this whole not being able to receive anything from compounding pharmacies. How are u getting ur test? Ur doc sends the script to a local pharmacy? If u do end up needing some estrogen control, u could always do the same thing with an ai. I used to have my doc send the script to my local pharmacy, and then use my insurance to get it pretty cheap.

Oddly it's just compounded goods; generics and regular drugs are no problem. I've asked my doc to just put in an rx for just standard 1mg anastrozole which I could cut into quarters, but man, I'd just rather not do it at all.

Other than that, I guess all u can do is lower ur dose, and/ or change the frequency of ur injections. But wouldn’t decreasing the frequency of ur injections possibly increase estrogen?

Yeah, this was my main question for the forum. Would changing things injection timing/frequency wise just make it worse?

Actually, maybe try out something like calcium d glucarate, to control high estrogen symptoms. Seems like some guys see positive results with it

Yeah, I take this along with DIM daily. Great stuff, no issues.

 

[Systemlord]

Is it simply that much better than injections and everyone is trying to spread the good word?

If you're having side effects and having trouble dialing in on injections, orals may be better.

 

[Gman86]

Yeah, I got that "obsessed libido" thing with the hot flashes for the first time since long ago when I was first getting my routine dialed in, so pretty sure it's high E2; not crazy high, just too high for me.

So annoying that high and low E2 symptoms can mimic eachother. Ur getting hot flashes with high E2, and in the past I’ve gotten horrible hot flashes when I crashed my E2 using ai’s

Oddly it's just compounded goods; generics and regular drugs are no problem. I've asked my doc to just put in an rx for just standard 1mg anastrozole which I could cut into quarters, but man, I'd just rather not do it at all.



Yeah, this was my main question for the forum. Would changing things injection timing/frequency wise just make it worse?

I think larger E2 spikes, from less frequent injections, could definitely make it worse. Everyone is different tho

Yeah, I take this along with DIM daily. Great stuff, no issues.

But do either help u in any way? Were u taking them both while u were on anastrozole?

 

[donkeyfarlo]

But do either help u in any way? Were u taking them both while u were on anastrozole?

Yeah, I've been on them for a couple years now. At one point a couple months ago I ran out of CDG and tried going without, and a surprising amount of anxiety showed up within a week or two, so I do believe it's having an effect.

 

[Guided_by_Voices]

My two cents...If a protocol is working well, don't change it!!!!! Or if you do and things get worse, go back to what worked ASAP. An overwhelming takeaway from the hormone space is that it is a very delicate balance and none of us knows what is really going on in our own bodies', much less someone else's body. You were in a good place which is a rare achievement. There are sources which sell the AI you were taking via mail, such as ADC. There are lots of other things that might help, such as PT-141, but IMO step one is always go back to what was working,

 

[donkeyfarlo]

My two cents...If a protocol is working well, don't change it!!!!! Or if you do and things get worse, go back to what worked ASAP. An overwhelming takeaway from the hormone space is that it is a very delicate balance and none of us knows what is really going on in our own bodies', much less someone else's body. You were in a good place which is a rare achievement. There are sources which sell the AI you were taking via mail, such as ADC. There are lots of other things that might help, such as PT-141, but IMO step one is always go back to what was working,

Thanks, and yeah I agree. If things don't improve within a couple weeks I'll be changing treatment to someone local who can actually get compounded stuff delivered here.

 

[donkeyfarlo]

I just wanted to follow up here to say aside from that one occurance I've been fine ever since with no AI. Thanks for all the advice and opinions.

I did want to ask a follow up to @Systemlord or anyone else with experience on the oral testosterone option... Would switching to Kyzatrex reverse testicular atrophy similar to HCG?

 

[Systemlord]

Would switching to Kyzatrex reverse testicular atrophy similar to HCG?

Oral testosterone is less suppressive than injectable testosterone.

Definitive answers on how an individual will respond to said therapy is impossible to predict. There’s no guarantees. Your mileage may vary.

Maybe you go on oral testosterone and you actually feel better and it does nothing for your testicle atrophy.