Totally Dialed In, Feeling Awesome, but where is the libido?

[KenLowT]

It took 5 weeks after dropping my dosage from 175mg a week to 100mg, but I finally feel great. After the emotional roller coaster, all the anxiety, the low moods, and the irritability, I think I'm finally dialed in. Last week was my roughest (Week 4), my mood was so low and my anxiety was through the roof, but something just clicked this week. The strength and endurance are still there, I have energy, but more importantly I'm chill. The only thing missing is my libido, which for me is the main reason I started TRT. I know I'm close, but I'm hoping this final piece comes soon. I'm seeing a very well recommended urologist next Tuesday and will decide to either stick with him or go with Defy depending on what he tells me. Today I spoke with Defy, ordered my bloodwork, in preparation just in case this doctor is just like all the other ones who have no clue how to treat me. I'm leaning towards Defy since I believe they can treat my thyroid issues as well, but I'm hoping for the best with this urologist.

How long did it take for you guys to get dialed in with libido? It's that missing piece that for me is the most elusive. I'm so relaxed right now that sex is the last thing on my mind. It's good to feel confident in the workplace in general society, now I just need to feel confident in the bedroom.

 

[sh1973]

Been trying to find that 8.5 years.

 

[Gman86]

Awesome to hear this Ken. It reinforces the fact that it really does take up to a month or two to get the positive effects back when making a dosage change. I would get labs done now that your settled on the new dosage. If free T could be better, and E2 isn’t too high, I would probably try upping the dosage a little. Other than that have you considered HCG? I feel like for me having bigger testicles and bigger loads correlates with increased libido. They seem to go hand and hand for me

 

[KenLowT]

Been trying to find that 8.5 years.

Wow, I really hope that things get better for you and for me.

 

[KenLowT]

Awesome to hear this Ken. It reinforces the fact that it really does take up to a month or two to get the positive effects back when making a dosage change. I would get labs done now that your settled on the new dosage. If free T could be better, and E2 isn’t too high, I would probably try upping the dosage a little. Other than that have you considered HCG? I feel like for me having bigger testicles and bigger loads correlates with increased libido. They seem to go hand and hand for me

No, I have not introduced HCG into my protocol yet because my endo wouldn't prescribe it alongside testosterone. She referred me to a urologist who would, but I'm probably gonna go with Defy anyway. I need to get my thyroid optimized which I'm sure the urologist will not do. At least if I try Defy I can kill two birds with one stone.

Also, I was on HCG Monotherapy from February-May before my insurance would stop covering it. It did absolutely nothing for me though. My Total T never got higher and my Free barely moved. It never gave me energy, no working libido, and I didn't feel the testes filling up. I definitely had more semen, but not like I thought considering how much I was taking in. My doc had me injecting 1000 units M,W,F. I hope that the combined therapy will perhaps make the HCG more effective. I actually got prescribed T after the HCG wasn't covered anymore and I struggling with withdrawal. The withdrawal was bad since I had to go cold turkey. Low libido, ED, anxiety, and depression.

 

[Gman86]

Interesting, so when you stopped the HCG and went on testosterone by itself your libido dropped, you had ED, anxiety and depression?

If that’s the case then it’s probably safe to assume that HCG would hopefully improve those symptoms if you added it back in right?

Oh did I read that wrong actually? Were you saying that after you were put on testosterone only, you stopped that cold turkey and that’s when the withdrawal symptoms started?

 

[Gman86]

You aren’t dialed in at 5 weeks. Maybe close but it’s too soon. I didn’t see hardly any libido increase at 100-120/wk. I sure did feel better. 140-150 kicked the libido up, but honestly e2 was lagging until that higher dosage. I FEEL pretty good when e2 is just low 20s but a little higher and libido kicks in.

Wow so you’re definitely a low E2 guy for sure. You don’t take an AI?

 

[Guided_by_Voices]

DHEA supplements and prolactin reduction through a low dose of Chasteberry are two things to experiment with, as could be mild estrogen lowering. I think, however, that this is one of the big unsolved problems in health. In my experience nothing fixes libido like being around super-hot woman (or your target being of choice) but there is no pill or injection for that unfortunately. Just giving things a bit of time to settle is likely key a well.

 

[KenLowT]

Interesting, so when you stopped the HCG and went on testosterone by itself your libido dropped, you had ED, anxiety and depression?

If that’s the case then it’s probably safe to assume that HCG would hopefully improve those symptoms if you added it back in right?

Oh did I read that wrong actually? Were you saying that after you were put on testosterone only, you stopped that cold turkey and that’s when the withdrawal symptoms started?

Not necessarily. I never had libido improvement in the four months I was solely on HCG. In fact, I rarely felt anything other than a slight improvement in energy. My mood never improved nor did my anxiety. For me it was completely ineffective other than giving me more semen. My ED came right after I was forced to stop the HCG cold turkey because of the insurance not covering it. For two weeks afterwards I got ED and depression so I caved and went for the testosterone to bring it back.

 

[KenLowT]

You aren’t dialed in at 5 weeks. Maybe close but it’s too soon. I didn’t see hardly any libido increase at 100-120/wk. I sure did feel better. 140-150 kicked the libido up, but honestly e2 was lagging until that higher dosage. I FEEL pretty good when e2 is just low 20s but a little higher and libido kicks in.

Since I'm a high body fat I'm sure that E2 is really high. When I started at 175mg per week it skyrocketed. I have a feeling I'm going to have to use an AI until I lose weight. Part of the problem is I've been in a "true" caloric deficit and I workout 6 days a week, but the weight never moves. I have Hashimoto's, but I'm still in the low normal range so my endo won't treat it. That's why my whole situation is complicated. I need the thyroid and T issues resolved. I'm wondering if the thyroid is working against my libido.

 

[Sean Mosher]

KenLowT...........once I started treating my thyroid libido drastically improved along with several other things as well.
Strength in the weight room, overall energy and mood greatly improved.
It's a must that you get someone qualified to treat you even if you're "within range" which means nothing for symptom resolution.

 

[DragonBits]

No, I have not introduced HCG into my protocol yet because my endo wouldn't prescribe it alongside testosterone. She referred me to a urologist who would, but I'm probably gonna go with Defy anyway. I need to get my thyroid optimized which I'm sure the urologist will not do. At least if I try Defy I can kill two birds with one stone.

Also, I was on HCG Monotherapy from February-May before my insurance would stop covering it. It did absolutely nothing for me though. My Total T never got higher and my Free barely moved. It never gave me energy, no working libido, and I didn't feel the testes filling up. I definitely had more semen, but not like I thought considering how much I was taking in. My doc had me injecting 1000 units M,W,F. I hope that the combined therapy will perhaps make the HCG more effective. I actually got prescribed T after the HCG wasn't covered anymore and I struggling with withdrawal. The withdrawal was bad since I had to go cold turkey. Low libido, ED, anxiety, and depression.

If HCG never brought your TT higher, then I doubt it's going to be any better along side testosterone. Maybe you are concerned with fertility, if so, that is a different issue.

BUT if HCG never did anything for you, how did you suffer from withdrawal? That would make me believe it was working.

 

[Vince Carter]

No labs...just stabbing in the dark. You can't have a substantive conversation with "Dialed in"...which would contradict this "no libido" part. Right?

 

[KenLowT]

If HCG never brought your TT higher, then I doubt it's going to be any better along side testosterone. Maybe you are concerned with fertility, if so, that is a different issue.

BUT if HCG never did anything for you, how did you suffer from withdrawal? That would make me believe it was working.

Yes, I am concerned about fertility. That's the only reason I would like to add the HCG as my wife and I want to have another child. My endo treated me exclusively with HCG because of that. I went to her for low libido, but the libido never went up while I was on it. It went from low to total crash when I got off of it.

 

[KenLowT]

No labs...just stabbing in the dark. You can't have a substantive conversation with "Dialed in"...which would contradict this "no libido" part. Right?

Sorry, dialed in for me meant that I'm feeling really good overall, just not with the libido yet. I am getting my labs done tomorrow on trough day. I'm really excited to see what the blood work shows.

 

[Guided_by_Voices]

If you are not losing fat while in a caloric deficit and high-activity state, then your body is trying to defend its fat level, likely through reducing your metabolic rate, which technically is not a thyroid issue, although you could have other thyroid issues. Low carb/keto and fasting seem to often help people in similar situations, and I know my libido suffered when I used to try to lose fat just by cutting calories before I went low carb.

 

[Gman86]

It doesn’t work this way. The aromatase activity due to body fat is highly overstated. Unless you get sub 10% I doubt it becomes a big factor. Read TRT stories of massive weight loss.

The way your body reacts initially to therapy isn’t necessarily how it will going forward. I can’t believe my hct was 47 last weekend. Up a point in 6 months. Hadn’t given blood in 9. Month 3 of trt at a lower dose my hct was 52 iirc.

I’ve mostly gone by feel in ai every since I zero’d in on high and low symptoms. Not saying I recommend that. Experiencing low e2 more than once sucks. I’ve felt consistently best on inconsistent and very small ai doses. Never once could be consistent AND have consistent mood and libido. I need less ai today than in past years. I don’t even know why.

E2 also lags after a change in protocol. I do not believe it’s peaked at 6 weeks based on my personal experience.

I’ve read lots of guys not need an ai or very little then they convert a lot suddenly just from aging.

What are the specific low and high E2 symptoms that you’ve learned to focus on to help you know whether you are on the high or low end?

 

[KenLowT]

If you are not losing fat while in a caloric deficit and high-activity state, then your body is trying to defend its fat level, likely through reducing your metabolic rate, which technically is not a thyroid issue, although you could have other thyroid issues. Low carb/keto and fasting seem to often help people in similar situations, and I know my libido suffered when I used to try to lose fat just by cutting calories before I went low carb.

I have a long family history of hypothyroidism. My mother has it, my aunt has it, both of my grandmothers had it. I'm pretty sure that my thyroid is working on it's last legs, but until my number goes below a certain point the endocrinologists of the world will do nothing. I've never had this much trouble losing weight. I used the same caloric deficit in the past, DID NOT EXERCISE, and I was able to lose over 90 lbs. Now my body just refuses to shed any body fat. I literally worked out for at least 5 months straight with weight training and diet and my waist never went down and my weight never dropped. In my opinion body fat composition is more important than weight, but that never changed.

 

[steveco1234]

What's your DHT at?

 

[DragonBits]

Yes, I am concerned about fertility. That's the only reason I would like to add the HCG as my wife and I want to have another child. My endo treated me exclusively with HCG because of that. I went to her for low libido, but the libido never went up while I was on it. It went from low to total crash when I got off of it.

I have no idea of what sort of hormone / lab test helps to indicate libido.

I know if my TT is below 400, I have fairly low libido, once a month I start thinking of sex.

But once I am above 500, it's strange. By that I mean average to crazy monkey sex high.

Most of the time I rate my libido as middle of the road. I can have sex once a day, but don't really want it every single day. Libido is always pretty good right near the beginning of TRT, the first couple of weeks, then it's more like when I was young. After that it sort of goes to middle of the road. When in the past after a couple of years of TRT my TT got to 902 ng/dl FT 27, I was like a raging teenager, it was so high it was annoying, I had sex 5 times a day. Maybe my libido soared because I injected earlier in a cycle of Nebido than normal, and my other hormones I didn't measure, like DHT were at appropriate levels. BUT right now I am at TT 1389 ng/dl and FT of 28.4, (E2 56) it "feels" no different than if I were at a TT of 600. Surely better libido than no TRT, but nothing special. Maybe I recover a little quicker from a workout, but it's kind of subtle, so maybe it's just because I know my levels.

So I am not sure why libido behaves differently and isn't solely dependant on TT/FT. Perhaps if you increase your TT too fast, it takes other hormones and receptors that aren't artificially enhanced time to "catch up".

You can see from the forum many other people are puzzled by TRT and their libido.